Outcomes after minimally invasive total knee replacement--a meta-analysis

A systematic review of randomised controlled trials reporting on the comparison of minimally invasive total knee replacement and standard incision technique was carried out. Online searches were performed in Medline, CINAHL, EMBASE, and the Cochrane Controlled Trials Register. Data concerning the endpoints postoperative pain, function, complications, and implant position were extracted in duplicate and pooled using fixed and random effects models. Weighted mean differences for postoperative pain showed 1.4 (95 % CI 1.8 to 1.0, p = 0.014) point better results for MIS. For function, standardised mean differences were calculated and showed better results for MIS, too (0.6 points, 95 % CI 0.03 to 1.12, p = 0.038). There were no significant differences in complication rates (OR 1.3, 95 % CI 0.6 to 2.9, p = 0.477) and implant position. Meta-regression showed no influence of navigation on any of the endpoints. Minimally invasive total knee replacement showed better postoperative pain and function without any differences in complication rates or implant position.