Complications during minimally invasive knee surgery

Since their advent, minimally invasive surgical techniques have achieved good results in knee arthroplasty, earning the approval of many orthopaedic surgeons. The advantages offered by this type of surgery are the respect of the extensor system, early functional recovery and reduced pain. As always in surgery, in order to obtain such results, various problems have been tackled, some of which have now been overcome thanks to the new instruments that are better suited to restricted incisions, whereas others still cause significant complications. The excessive forces exercised on the soft tissues and patella can damage the tissues despite the less invasive incision. All the statistics provided by surgeons who most frequently use these techniques show complications due to the use of a minimally invasive technique that can be avoided with the standard techniques, which have given outstanding results for a long time. Above all, implantation accuracy appears to be reduced through a small incision. The highest complication rates are reported in the quadriceps-sparing technique, which does not allow a perfect view of the joint. In this review, we highlight the possible complications associated with this "new" surgical approach, which still requires further evolution in order to achieve the same results as the standard technique. © Springer-Verlag Italia 2007.