Early Perioperative Recovery Patterns Across Diverse Minimally Invasive Orthopedic Procedures: A Prospective Cohort Study

Minimally invasive orthopedic surgery (MIOS) has been increasingly adopted to reduce surgical trauma and facilitate postoperative recovery. However, few datasets describe real-world early recovery across diverse minimally invasive procedures. This prospective observational cohort study enrolled 200 adult patients who underwent minimally invasive orthopedic surgery at a tertiary academic center between 15 December 2022 and 31 December 2024. Procedures included minimally invasive spine surgery, minimally invasive total knee arthroplasty (TKA), minimally invasive total hip arthroplasty (THA), percutaneous sacroiliac joint fusion (SI arthrodesis), and arthroscopic or percutaneous fixation procedures. Primary outcomes were hospital stay, time to independent ambulation, VAS pain score, and patient-reported functional outcome. Secondary outcomes included operative time, blood loss in the operating room, complications, readmission, and reoperation. The median hospital stay was 2.1 days (interquartile range [IQR] 1.4-2.9), and the median time to independent ambulation was 1.6 days (IQR 1.1-2.1). Mean operative time was 91.1 ± 24.0 minutes, and mean estimated blood loss was 136.6 ± 47.7 mL. Preoperatively, patients had a mean VAS pain score of 7.2 ± 1.1, which decreased to 3.1 ± 0.8 at hospital discharge. There was a significant improvement in functional outcome for all procedure categories (p < 0.001). The overall incidence of complications was 7.5% (95% CI 3.8-11.2%). The 30-day readmission rate was 2.0% (n = 4), and the 90-day reoperation rate was 1.0% (n = 2). These findings characterize early perioperative recovery trajectories across five categories of minimally invasive orthopedic procedures, providing benchmark recovery timelines to support preoperative patient counseling and inform future comparative studies.