A meta-analysis of randomised controlled trials comparing the clinical and radiological outcomes following minimally invasive to conventional exposure for total knee arthroplasty

Proponents of minimally invasive total knee arthroplasty (TKA) state accelerated patient recovery and increased patient satisfaction as advantages. However, retractors state a greater incidence of iatrogenic nerve injury, implant mal-positioning and increased rates of revision. This study compares the clinical and radiological outcomes of minimally invasive and conventional exposure TKA using a meta-analysis. A search of published and unpublished literature was performed. Eighteen studies including 1582 TKAs were reviewed: 822 minimally invasive versus 760 conventional exposure TKAs. The findings of this study suggest that whilst incision length was significantly smaller in MIS (p = 0.001), and flexion range of motion was significantly greater following MIS (p = 0.01), there was no statistically significant differences in all other clinical or radiological outcomes between MIS or conventional approach TKA surgery (p>0.05).