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Minimally invasive surgery did not improve outcome compared to conventional surgery following unicompartmental knee arthroplasty using local infiltration analgesia A randomized controlled trial with 40 patients
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Orthopedic Surgery, University Hospital, Örebro, Sweden.
Department of Anesthesiology and Intensive Care, Örebro University, University Hospital, Örebro, Sweden.
Department of Orthopedic Surgery, Örebro University, University Hospital, Örebro, Sweden.
Department of Physiotherapy, Örebro University, University Hospital, Örebro, Sweden.
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2012 (English)In: Acta Orthopaedica, ISSN 1745-3674, E-ISSN 1745-3682, Vol. 83, no 6, 634-641 p.Article in journal (Refereed) Published
Abstract [en]

Background and purpose: There has recently been interest in the advantages of minimally invasive surgery (MIS) over conventional surgery, and on local infiltration analgesia (LIA) during knee arthroplasty. In this randomized controlled trial, we investigated whether MIS would result in earlier home-readiness and reduced postoperative pain compared to conventional unicompartmental knee arthroplasty (UKA) where both groups received LIA.

Patients and methods: 40 patients scheduled for UKA were randomized to a MIS group or a conventional surgery (CON) group. Both groups received LIA with a mixture of ropivacaine, ketorolac, and epinephrine given intra-and postoperatively. The primary endpoint was home-readiness (time to fulfillment of discharge criteria). The patients were followed for 6 months.

Results: We found no statistically significant difference in home-readiness between the MIS group (median (range) 24 (21-71) hours) and the CON group (24 (21-46) hours). No statistically significant differences between the groups were found in the secondary endpoints pain intensity, morphine consumption, knee function, hospital stay, patient satisfaction, Oxford knee score, and EQ-5D. The side effects were also similar in the two groups, except for a higher incidence of nausea on the second postoperative day in the MIS group.

Interpretation: Minimally invasive surgery did not improve outcome after unicompartmental knee arthroplasty compared to conventional surgery, when both groups received local infiltration analgesia. The surgical approach (MIS or conventional surgery) should be selected according to the surgeon's preferences and local hospital policies.

Place, publisher, year, edition, pages
New York, USA: Informa Healthcare, 2012. Vol. 83, no 6, 634-641 p.
National Category
Orthopedics
Research subject
Orthopaedics
Identifiers
URN: urn:nbn:se:oru:diva-55675DOI: 10.3109/17453674.2012.736169ISI: 000311679900015PubMedID: 23043272Scopus ID: 2-s2.0-84870274900OAI: oai:DiVA.org:oru-55675DiVA: diva2:1073990
Available from: 2017-02-14 Created: 2017-02-14 Last updated: 2017-10-18Bibliographically approved

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