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Updated: Jun 13, 2026

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
Surgical techniques for minimally invasive exposures for total knee arthroplasty
Peter M Bonutti1, Michael G Zywiel, Mike S McGrath
1Bonutti Clinic, Effingham, Illinois, USA.
Abstract:
The anterior medial parapatellar approach has long been the standard approach for total knee arthroplasty. Although this approach uses a simple, reproducible technique, some patients have reported lasting functional limitations after the surgery. Recently, marked interest has arisen in developing minimally invasive surgical approaches, implants, and instruments with the aim of improving patient outcomes. Five principal surgical approaches-the mini medial parapatellar, the quadriceps muscle-sparing, the mini-midvastus, the mini-subvastus, and the direct lateral-are most commonly used with minimally invasive techniques. Understanding the benefits and drawbacks of each approach as well as the reported results will aid orthopaedic surgeons in selecting the best treatment option for their patients.
