The Current Role of Minimal Invasive Surgery in Orthopaedics – A General Overview

Abstract

The goal of minimal invasive surgery (MIS) is to reduce surgical trauma and shorten recovery. The scope of MIS in orthopaedics and traumatology is very wide. The current article is a brief overview of the status of MIS in fracture repair, spine surgery, joint replacement surgery, sport and arthroscopic surgery. Such goal is not always achieved in all clinical scenarios. The use of modern intramedullary nails and sub-muscular plating has revolutionized orthopaedic trauma care in the past two decades. There is much evidence supporting routine use for lower limb fractures. In the upper limb fractures, evidence still supports open surgery to play a large role. For joint replacement surgery of the knee and hip, evidence has pointed out the lack of benefit, steep learning curve and higher risk of complications and is therefore not widespread. For spine surgery, MIS has a recognized role in spine trauma, degenerative lumbar conditions, spinal metastasis and deformity correction with some limitations to overcome. For sports surgery, arthroscopic treatment is becoming the standard of care of intraarticular conditions involving large joints, with indications expanding to smaller joints. Advancement in computer navigation, intraoperative advanced imaging and 3D printing is enabling new horizons for MIS in orthopaedics. The benefits of MIS are realized via technological innovations and proficient surgical skills. For most conditions, MIS is performed depending on surgeon preference, and clear indications for routine use remains to be defined by high quality clinical studies.