Minimally Invasive Total Knee Arthroplasty Does Not Improve Outcomes 1 Year after Surgery: A Randomized Controlled Trial
Bibliographic record
Abstract
Background: Within the past few years, minimally invasive surgical (MIS) techniques fortotal knee arthroplasy (TKA) have emerged as promising alternatives to conventional TKA, possibly because of less surgical trauma to the quadriceps. The purpose of this investigation was to evaluate the efficacy of MIS TKA outcomes compared to conventional TKA. Methods: Forty-four patients, aged 50-85 years (64.3 ± 8.4 mean ± SD; 22 females, 22 males) who were scheduled for a unilateral TKA secondary to osteoarthritis were enrolled in a prospective randomized controlled trial. Patients were excluded if they had cardiopulmonary, neurological, or other unstable orthopedic conditions that limited function; uncontrolled diabetes; or a BMI ≥ 40 kg/m2. Patients were blinded and randomly assigned to one of two surgical groups: MIS or conventional. All patients completed a standardized course of rehabilitation following surgery. Patients were assessed preoperatively and 4, 12, 26, and 52 weeks postoperatively by a blinded evaluator; the 26- and 52-week outcomes are the focus of the present manuscript. Outcomes included isometric quadriceps strength (primary outcome), isometric hamstrings strength, quadriceps activation, active knee range of motion (AROM), the six-minute walk (6MW) test, pain at rest and with 6MW, timed-up-and-go test (TUG), the stair climbing test, the Short Form 36 Health Status questionnaire (SF-36) the Western Ontario and McMaster Osteoarthritis Index (WOMAC), and leg muscle mass. Results: There were no differences between groups at baseline. At 26 and 52 weeks postoperatively, there were no difference between MIS and control groups for any outcome measure. Conclusions: Although the MIS surgical technique for TKA may lead to faster recovery of strength in patients undergoing TKA (previously reported at 4 weeks postoperatively), there is no apparent benefit of MIS on the longerterm recovery of strength or functional performance. Therefore, the benefits of MIS TKA may not outweigh the risks associated with limited surgical visualization.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".