When it comes to total knee replacement surgery, one important part of the procedure
is how your surgeon accesses the knee joint. This is known as the surgical approach, and it can influence your recovery, comfort, and overall experience after
surgery.
Two of the most common approaches are the medial parapatellar approach and the
subvastus (muscle-sparing) approach. The image above shows the difference in
how each approach is performed.
Medial Parapatellar Approach
This traditional technique involves an incision that goes along the inside of the kneecap
and through part of the quadriceps tendon to access the joint. It provides good visibility
and is widely used by surgeons around the world.
Subvastus (Muscle-Sparing) Approach
The subvastus approach takes a different path. Instead of cutting through the tendon,
the surgeon gently lifts the vastus medialis muscle (part of your quadriceps) and
works underneath it. This avoids cutting the main tendon above the kneecap, which can
be appealing for patients focused on muscle preservation.
What Are the Potential Benefits?
Some patients who have the subvastus approach may:
- Experience less discomfort in the early days after surgery
- Regain muscle strength and control a little earlier
- Be up and moving sooner as part of their rehab program
- Notice less swelling and better movement in the first few weeks
The idea behind this approach is to minimise disruption to the muscles that power your
knee — which may help make recovery feel a little smoother for some people. However,
outcomes can vary, and both techniques have been used successfully in many
thousands of patients.
So Which Approach Is Better?
There’s no one-size-fits-all answer. The best approach depends on a range of things —
including your body type, joint condition, level of activity, and your surgeon’s
recommendation based on experience and what’s safest for your knee.
What’s most important is that the chosen approach allows your surgeon to position the
implant accurately and achieve a stable, well-functioning joint.
