• 作者：J. Jimé ; nez-Cristó ; bal ; ^{javierjimenezcristobal@gmail.com} ; P. de la Cuadra-Virgili ; P. Torrijos-Garrido ; S. Bartolomé ; -Garcí ; a ; J.L. Vilanova-Vá ; zquez
• 关键词：Pró ; tesis total de rodilla ; Cirugí ; a mí ; nimamente invasiva ; Quad sparing ; Curva de aprendizaje ; Subvasto
• 刊名：Revista Espa帽ola de Cirug铆a Ortop茅dica y Traumatolog铆a
• 出版年：2011
• 期刊代码：pca311_18884415
• 类别：med
• 出版时间：November-December 2011
• 卷：55
• 期：6
• 页码：420-427
• 文件大小：320 K

Background

Minimally-invasive total knee arthroplasty performed by orthopaedic surgeons who are specialised in total knee arthroplasty leads to similar functional results and rates of complications as conventional procedures. The aim of this study is to find out whether this can be extrapolated to general orthopaedic surgeons, and also to describe the learning curve in this procedure.

Material and methods

We included 259 patients over a three year period. The population was divided into 10 groups, 26 knee replacements in each group, allocated in chronological order. The following variables were recorded: hospitalisation in days, radiological angles, length of incision, tourniquet time, complications, Hospital for Special Surgery (HSS) score, haemoglobin values and need for blood transfusion.

Results

The mean number of hospitalisation days decreased from 7.9 to 6.2 days. Mean tourniquet time decreased from 120 卤 15 to 95 卤 20 minutes. Packed red blood cells adminsitration decreased from a median of 2 packed cells to 0. Mean incision length increased from 8 卤 0.5 to 9.5 卤 1.1 cm. Complications dropped from 11.5%to 3.8%. No differences were observed in the radiological angle of the prosthesis and HSS scores of patients in the different groups, 6 months and one year after surgery.

Conclusions

Minimally-invasive total knee replacement surgery (MIS) can be performed by general orthopaedic surgeons with results that are comparable in the medium-term with conventional surgery, and with the short-term advantages afforded by MIS. The learning curve was 26 knee replacements. The variables that improve were tourniquet time, need for blood transfusion and length of hospitalisation. The final functional result and radiological positioning were not affected.