Minimally invasive lateral approach to total knee arthroplasty

Minimally invasive knee surgery can be accomplished through several exposures used in standard total knee arthroplasty. These exposures include the medial parapatellar, subvastus, and midvastus approaches. The authors describe a new minimally invasive direct lateral approach in an attempt to minimize soft tissue damage and preserve quadriceps muscle function in 35 patients (35 knees). There were 23 women and 12 men with a mean age of 65 years. At a mean follow-up of 3.8 years, the mean Knee Society objective and functional scores improved to 94 and 92 points, respectively. The assessment of quadriceps muscle strength, anterior knee pain, and patient satisfaction was promising. However, the downside of this pilot cohort was that using instruments and implants that have not been customized for this approach led to a considerable rate of early complications that may limit the potential of this new approach. Thus, further refinements are needed to increase clinical success and allow this technique for general use.