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Reply: Mini-incision Total Knee Arthroplasty can Increase Risk of Component Malalignment

Dalury, David, F; Dennis, Douglas, A

Clinical Orthopaedics and Related Research: August 2006 - Volume 449 - Issue - p 320
doi: 10.1097/01.blo.0000229282.60732.23
SECTION III: REGULAR AND SPECIAL FEATURES: Letters to the Editor
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1Towson Orthopaedics Assoc., Baltimore, MD; and2Colorado Joint Replacement, Denver, CO

Reply:

We appreciate Dr. Rodriguez's careful reading of our manuscript. We agree that the major difference between the two groups was the length of the incision. As per most recommendations for minimally invasive surgery of the knee we did attempt to use a quadriceps-sparing incision (midvastus) whenever possible and prepared the patella first whenever we thought it was advantageous. It certainly is possible that specialized instruments and implants and lack of patellar eversion can improve outcomes in mini- incision total knee replacement, but this has yet to be proven.

We agree that minimal-incision knee surgery is much more than simply a smaller incision. We look forward to additional examination of the role of different incisions, instruments, implants, and improved perioperative education and pain control in improving outcomes. The point of our paper was to point out the potential dangers of small- incision knee surgery using current instruments and implants.

David F. Dalury, MD

Towson Orthopaedics Assoc. Baltimore, MD

Douglas A. Dennis, MD

Colorado Joint Replacement Denver, CO

© 2006 Lippincott Williams & Wilkins, Inc.