Comparison Of Minimal-incision Midvastus And Standard Medial Parapatellar Approaches For Total Knee Arthroplasty: A Meta-analysis

Objective To evaluate the efficacy and safety of the mini-midvastus(Mini-MV)approach in the total knee arthroplasty(TKA).Methods The Cochrane Library,Pub Med,SINO,and CBM were searched to identify the clinical trials comparing the mini-midvastus approach with the medial parapatellar(SMP)approach in TKA.The quality of the included studies was critically assessed by two assessors independently and the data analyses were performed by the Cochrane Collaboration s Rev Man 5.3.Results 20 studies were included,all of them are randomized controlled trials(RCTs),including 6.The Mini-MV TKA group consisted of 679 knees,and the SMP TKA group consisted of 677 knees.All trails were identified as meeting all the eligibility criteria.The meta-analysis did not find significant differences in the postoperative complications,blood loss,postoperative Knee Society objective scores,functional Knee Society scores,operative time and component alignments.There were advantages in the short term VAS,flexion range of knees and the incision length for the Mini-MV approach to SMP approach.Conclusion Based on the current evidence,the Mini-MV approach for total knee arthroplasty is as safe and effective as the medial parapatellar approach,but smaller incision leads to faster functional recovery of the knees.Due to the poor quality of the included trials,more high-quality RCTs are needed.