Minimal Incision Total Knee Replacement Surgery

A quicker, less painful recover than the traditional knee replacement

Knee Pain - ReplacementOver 300,000 total knee replacements are performed in the United States every year. The traditional procedure has been used successfully to straighten mal-aligned knees, eliminate arthritis pain, restore range of motion and maximize function. Knee replacements have been performed by orthopedic surgeons for over 30 years. However, patients usually have to endure a prolonged period of disability until they are fully recovered. It is due to this fact that surgeons and their patients have been searching for an alternative method of knee replacement that could be less invasive.

Millions of people in the United States suffer from knee arthritis and its associated pain and disability. Before considering knee replacement surgery, patients should first try non-operative treatments such as medication, physical therapy, braces and injections. In many cases, these can be very helpful. However, when the progressive deterioration of the joint leads to severe pain and deformity, patients will often choose total knee replacement as a solution.

The goal of the “mini total knee” is to be less disruptive to the tissues. This leads to decreased pain and blood loss and ultimately a more rapid restoration of function through improved strength, functional walking ability and improved range of motion.

Traditional knee replacement surgery involves the insertion of a plastic and metal artificial joint into the knee through an 8-11 inch incision. Patients usually undergo several months of extensive physical therapy in order to regain their knee strength, range of motion and function.

Over the last few decades, surgeons have developed less invasive techniques to treat a wide variety of problems. Laparoscopic surgery, microsurgery and arthroscopic surgery have all been utilized to treat common problems with less damage to the surrounding tissues.

Total joint surgery has also evolved as surgeons recognized that damage to the surrounding soft tissue led to more pain and longer recovery time for the patient. The critical element for this shorter recovery seems to be avoiding harm to the quadriceps or thigh muscle. Once this fact was recognized, it became a matter of developing appropriate equipment and techniques to allow surgeons to remove arthritic tissue without harming the quadriceps muscle.

Although the technique for this surgery has changed, the implants that are used have not. The implants have a solid track record both in durability and function. Why change a good thing? The improvement is how they are implanted which allows us to achieve excellent outcomes.

Minimally invasive vs. traditional knee replacement

There are 2 main differences between minimally invasive total knee and traditional total knee surgery.

  1. The “minimally invasive” surgery is done through a much smaller incision, approximately 3 to 5 inches in length, instead of the 8-11 inch incision used in the traditional total knee surgery.
  2. The quadriceps muscle and tendon, which is cut in the traditional total knee, is spared or minimally cut. This results in less trauma to the knee and surrounding muscles with a quicker and less painful recovery.

There are 2 types of minimally invasive total knee replacement surgeries. The first is known as a “quad sparing” total knee approach, in which the quadriceps muscle on the front of the thigh is not cut. The other surgery type is the mini total knee procedure. In this procedure, a 1 to 2 centimeter cut is made in one of the quadriceps muscles. Both procedures yield excellent results. The choice to use one procedure over the other is based upon the patient’s size, range of motion and joint deformity.

Not all candidates for a total knee replacement are good candidates for the minimally invasive knee replacement. Patients that are obese are not good candidates due to the size of their knee. Patients that have had prior knee surgery (except arthroscopy) are also not good candidates, as there may be a lot of scar tissue that prevents the surgeon from adequately accessing the joint through such a small incision.

Although the “mini knee” takes longer to do, we feel that the benefit to the patient is substantial. The goal of the “mini total knee” is to be less disruptive to the tissues. This leads to decreased pain and blood loss and ultimately a more rapid restoration of function through improved strength, functional walking ability and improved range of motion. Just another example of our goal at Muir Orthopaedic Specialists – “Old fashioned caring and leading edge care.”

If this procedure is of interest to you and you would like more information, please contact us to request an appointment with one of our orthopedic specialists in Brentwood, San Ramon or Walnut Creek.