MIS: Why mess with excellence? Although it may have benefits, MIS does not have data to warrant its widespread use.
By Robert L. Barrack, MD
ORTHOPEDICS TODAY 2008; 28:61
Minimally invasive surgery is probably the only topic that outpaces the gender issue in orthopedics in terms of interest and media attention. In fact, if you look at the Internet, there’s about a half-million sites that address MIS; only a handful of which have any data. If you look at the medical literature, there are a little over one-hundred articles and only 20 or so of them have any outcomes data. That gives us a ratio of promotion to science of about 13,000:1…
…The long term results of TKA have been excellent and with improvements in perioperative management we are really going to be hard pressed to improve on these excellent results. MIS does hold some promise in reducing perioperative morbidity and possibly improving short-term outcomes, but the data is not compelling enough to establish a clear advantage over standard TKA at present. The advantages reported currently may be due to selection and observer bias and the level of skill of the reporting surgeons.