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SUBVASTUS APPROACH, THE ONLY TRUE MIS APPROACH



Abstract

The majority of papers covering MIS total knee describe a surgical approach where the quads tendon is violated. This presentation describes a modified subvastus approach using MIS technique. The results are compared to the regular subvastus approach.

Material and methods: 423 total knee replacements were performed through MIS subvastus approach from November 2002 to February 2004. All cases were performed by the same surgeon. The subvastus approach was modified to allow more quads excursion so the surgery can be performed without dislocating the patella. The data was processed at University of Dundee. The results were compared to the results of 361 cases of standard subvastus approach performed by the same surgeon.

Kanasaki et al. (ISTA 2002) has shown that patients who had subvastus approach were able to regain the ability to do a straight leg raising faster than the standard parapateller incision. The results in this paper confirm the same showing that the ability of patients to rehabilitate is not related only to the size of the incision. Having relatively small incisions help in shorten hospital stay but did not make any difference in blood loss. The subvastus approach the only true quad sparing approach and it can be performed through 10 cm incision safely even in heavy patients with severe knee deformity.

Correspondence should be addressed to Richard Komistek, PhD, International Society for Technology in Arthroplasty, PO Box 6564, Auburn, CA 95604, USA. E-mail: ista@pacbell.net