A Comparison of Subvastus and Midvastus Approaches in Minimally Invasive Total Knee Arthroplasty

By Peter M. Bonutti, MD, Michael G. Zywiel, MD, Slif D. Ulrich, MD, D. Alex Stroh, BS, Thorsten M. Seyler, MD, and Michael A. Mont, MD

J Bone Joint Surg Am. 2010;92:575-82 d doi:10.2106/JBJS.I.00268

Abstract: The mini-subvastus and the mini-midvastus approaches are among the most common alternatives to the medial parapatellar approach for total knee arthroplasty. The purpose of this study was to compare the early clinical outcomes of these two approaches.

Conclusions: The minimally invasive subvastus and midvastus approaches for total knee arthroplasty were both associated with excellent short-term clinical results. Some surgeons believe that the subvastus approach completely avoids damage to the quadriceps mechanism and therefore would be associated with improved muscle function. This prospective series did not identify a substantive difference between the two approaches. We believe that the decision between these surgical approaches should be based on surgeon preference and experience.