Anterolateral skin incision for total knee arthroplasty is associated with lower prevalence of postoperative hypoesthesia at 1-year: a meta-analysis of randomised trials.

Study Summary

8 randomized controlled trials including 609 patients over the age of 18 years undergoing elective primary total knee arthroplasty (TKA) were included in this systematic review and meta-analysis comparing an anterolateral skin incision (ALI) with a standard midline or anteromedial skin incision. Pooled outcomes of interest included postoperative hypoesthesia, surface area of skin numbness, knee flexion, Visual Analogue Scale (VAS) pain, Forgotten Joint Score (FJS), and Knee Injury and Osteoarthritis Outcome Score (KOOS). The anterolateral incision significantly reduced the prevalence and surface area of postoperative numbness at 1 year, while no significant differences were observed in pain, knee flexion, KOOS, or FJS. Overall, the findings suggest that the anterolateral skin incision is an effective alternative that minimizes postoperative sensory disturbance without compromising functional or patient-reported outcomes after TKA.