Minimally Invasive Muscle Sparing Knee Replacement
Total knee replacement is a very successful surgical treatment for knee arthritis. Over the years, minimally invasive knee replacement surgical techniques have been developed to lessen tissue trauma and improve patient outcomes.
Minimally invasive muscle sparing joint replacement includes:
- Small incision 4-6 inches
- No cutting of the quadricep tendon (compared to traditional techniques with cut the quadricep tendon)
- No thigh tourniquet used during the surgery which means less thigh pain and weakness
- Avoiding general anesthesia and breathing tube
- Reduced post-operative pain
- Discharge home same day as surgery
- Ambulating without walker or cane on average 2 weeks after surgery
Minimally invasive muscle sparing knee replacement involves the use of smaller incisions which are only 4 to 6 inches in length as compared to the 10-12 inch long incision used in the traditional procedure.
Surgery is performed under sterile conditions in the operating room under spinal anesthesia as well as a nerve block around the knee. This avoid general anesthesia and a breathing tube. Thigh tourniquet is not used during the surgery so there is no post operative pain or thigh weakness.
Your surgeon will then make a curved incision around the kneecap compared to the traditional midline incision. Patient will be able to bend the knee with less pain and be able to kneel sooner.
The knee joint is accessed by lifting off the quadricep tendon and muscle thus a muscle sparing approach compared to the traditional approach which usually cuts the tendon and muscle. This leads to better early range of motion, less bleeding, less weakness and less pain.
The surgeon first focuses on the femur (thighbone). The damaged portions of the femur are cut at the appropriate angles using specialized tools.
Then the femoral component is attached to the end of the femur with or without bone cement. The next step involves removal of the damaged area of the tibia (shinbone) and the cartilage. It allows for a smooth surface to which implants can be attached.
The tibial component is then secured to the end of the bone with or without cement, also called press-fit for natural bone ingrowth. Your surgeon will place a plastic piece called an articular surface between these implants to ensure a smooth gliding movement.
This plastic insert acts in a similar way as the original articular cartilage and helps in supporting your body weight as well as allows the femur bone to move over the tibia. The femur and the tibia bone with their new components are put together to form the new knee joint.
To ensure that the patella (knee cap) glides smoothly over the new artificial knee, its rear surface is prepared to receive a plastic component. With all its new components in place, the knee joint is examined through its range of motion.
The incision is closed with surgical glue leaving the patient with minimal post-operative wound care. A surgical dressing or bandage is then placed over the incision.
As there is less tissue damage around the knee during the minimally invasive surgery, you can expect a shorter hospital stay, faster recovery with the added benefit of a small surgical scar.
Most Common Questions
In this video Dr. Florian Dibra answers the most common questions he gets from his patients about knee replacement surgery.
This patient is 2 weeks out of surgery and walking without a walker or a cane. Impressive!
Dr. Dibra performed this surgery without using general anesthesia, no muscle cutting approach and press fit implants (no cement). Local anesthesia is safer as it uses less medications and avoids breathing tube. Muscle sparing approach means the patient has stronger quad muscle and recovers quicker with less pain. Press fit implants allow for more natural bony ingrowth and avoidance of cement which can fail over time. Most importantly, patients can go home safely same day after their surgery.