THE MINI-INCISION: MORE HYPE THAN HELP! – IN THE AFFIRMATIVE

Abstract

The current growing enthusiasm for unicompartmental and “minimally invasive” arthroplasties is in no small part predicated on the appeal of a mini-incision. While the quest for ever less intrusive surgical procedures is certainly laudable, the appropriate focus should be more on the quality of the procedure and its results, than on cosmetics and recuperative time. The marketing appeal of a “mini-incision” is undeniable, although it is often used as a “bait and switch” technique for attracting surgical candidates. It is undeniable that expense, pain, and time out of work may be less with these procedures. On the other hand, performing an arthroplasty through a minimal incision increases the complexity and difficulty for surgeons, a reality, which is usually inversely proportional to the quality of the result. Our societal quest for speed may divert our attention from the fact that these are temporising procedures at best, whose longterm success in the general marketplace is completely unknown and which may suffer the fate of other such minimally invasive techniques as interpositional skids, viscosupplementation, and abrasion chondroplasty. The extremely high and long lasting success rates of conventional total knee arthroplasty are difficult to approach, and we are indeed sending a mixed message to our patients when we attempt to sell lesser technologies based on small scars. As we all know, size does matter!