Minimally Invasive Total Knee Arthroplasty
Minimally invasive total knee arthroplasty (MIS TKA) was developed primarily due to patient demand for less pain, faster recovery, and, it was hoped, improved functional results. Traditional total knee arthroplasty (TKA) consisted of a technique of a supine patient, tourniquet, incision of 6–12 in., median parapatellar approach, everted patella, and dislocated tibiofemoral joint with large bulky instruments that may increase trauma to the soft tissue and prolong recovery.
We began developing MIS knee arthroplasty techniques in 1991 with the goal of reducing overall soft tissue trauma and sparing quadriceps mechanism. After instrumentation and techniques were developed, in 1999 we began performing MIS TKA on selected patients. Our goals were to (1) reduce incision size (12 cm or less); (2) avoid everting the patella; (3) use muscle-sparing techniques – vastus medialis oblique (VMO) snip (mini-midvastus); (4) use downsized instrumentation; and (5) make in situ bone cuts.
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