MIS: A Risk Factor of Early TKA Failure—Opposes

The major causes of early failure of total knee replacments are infection, malposition, instability, and aseptic loosening. Using a mini-midvastus minimally invasive exposure we have not noted an increase in any of these parameters compared with knee replacement that we had performed using a standard median parapatellar approach. The mini-midvastus approach allows visualization of the knee in a manner analogous to that with larger incisions thereby enabling standard bone resections and ligamentous balancing. It has allowed us to use standard total knee components inserted with modified instruments to allow positioning through the smaller capsular exposure. Other minimally invasive exposures, especially the quad sparing technique have, in contradistinction, been reported to have some increase in such complications such as femoral fracture, instability, and malposition.