Minimally Invasive Knee Arthroplasty

All patients were operated on under spinal anesthesia in a supine position, by a single, non-designer surgeon experienced in knee and hip arthroplasty. No tourniquet was used. A standard mini-medial parapatellar approach was used for all patients. A routine inspection of the patellofemoral and lateral compartments was conducted. The integrity of the cruciate ligament was evaluated. The medial and intercondylar osteophytes were removed. An anterior tibial pre-cut was performed to allow articular exposure. The PPK system (Zimmer, Warsaw, Indiana, USA) was implanted using the corresponding instrumentation, extramedullary tibial guide, and the femoral and tibial cutting guides by following manufacturer instructions [22 ]. All the components were cemented using Refobacin® Bone Cement R (Zimmer-Biomet, Warsaw, Indiana, USA). One closed suction subcutaneous drain was used and removed on the first postoperative day. The postoperative rehabilitation protocol was identical for all patients and followed published guidelines [23 (link)].