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Comparative Study
. 2015 Jun;23(6):1699-705.
doi: 10.1007/s00167-014-3154-7. Epub 2014 Jul 4.

Mini-midvastus total knee arthroplasty does not result in superior gait pattern

M C Liebensteiner  1 , M Thaler, J M Giesinger, S Fischler, D C Coraça-Huber, M Krismer, E Mayr
Affiliations
Comparative Study

Mini-midvastus total knee arthroplasty does not result in superior gait pattern

M C Liebensteiner et al. Knee Surg Sports Traumatol Arthrosc. 2015 Jun.

Abstract

Purpose: Previous studies dealing with gait after minimally invasive surgery (MIS) total knee arthroplasty (TKA) are rare and insufficient. It was the purpose of the study to determine in a prospective, comparative setting whether MIS influences the outcome of TKA in terms of typical 3D gait parameters.

Methods: Patients scheduled for TKA or MIS TKA were invited to participate. MIS TKA was defined as TKA with shorter skin incision, mini-midvastus arthrotomy, special instruments, and avoidance of tibiofemoral dislocation and patella eversion. All other intra- and perioperative aspects were identical for both groups. A 3D gait analysis was performed with a VICON system 1 month preoperative and 8 weeks post-operative. A multivariate analysis of variance was conducted including the main effects time (pre- and post-surgery) and surgical group and the group-by-time interaction effect.

Results: Seventeen MIS TKA patients and 20 TKA patients were eligible for the final analysis. We determined neither inter-group differences nor time × group interactions for any gait variables (temporospatial, ground reaction forces, joint angles and joint moments)—except for the varus-valgus knee kinematics. In pre- to post-operative comparison, the maximum valgus sway increased in the MIS group, whereas it decreased in the conventional group (p = 0.001).

Conclusion: From our findings, it was concluded that MIS TKA does not result in a superior walking pattern 8 weeks post-operative. Because we previously also observed mini-midvastus MIS TKA to have equal or slightly inferior results with regard to knee scores, knee torque, radiographic outcome and tourniquet/operating time, we discontinued the procedure.

Level of evidence: Prospective comparative study, Therapy, Level II.

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