MIS TKA with a subvastus approach

Performing minimally invasive (MIS) total knee arthroplasty (TKA) through a subvastus approach makes sense on an anatomic basis, on a scientific basis, and on a practical basis. Anatomically, the subvastus approach is the only approach that saves the entire quadriceps tendon insertion on the patella [1-5] (Fig. 1). Scientifically, the subvastus approach has been shown, in prospective randomized clinical trials, to be superior to the standard medial parapatellar arthrotomy and to the so-called quadriceps-sparing arthrotomy [3, 6, 7] (Table 1). Practically, MIS TKA with a subvastus approach is reliable, reproducible, and efficient and allows the MIS technique to be applied to a broad group of patients, not just a highly selected subgroup [8] (Table 2).