@corycalendinemd: Every knee replacement starts with the same decision: how to get into the joint. The skin incision looks nearly identical from patient to patient. What changes is the layer underneath it. That layer is called the arthrotomy, and three approaches account for most primary knee replacements. The medial parapatellar approach is the reference standard. The quadriceps tendon is divided above the kneecap and repaired at the end of the case. It gives the widest exposure of the femur, tibia and patella, extends easily when a knee is stiff or deformed, and stays reliable in revision surgery. The cost is that the extensor mechanism is cut, so quadriceps control returns more slowly. The midvastus approach leaves the quadriceps tendon intact and splits the vastus medialis along its fibers instead. Exposure is close to the standard approach, blood loss tends to be lower, and fewer lateral releases are needed. The tradeoff is that the muscle belly is still divided, and its nerve supply can be affected. The subvastus approach lifts the vastus medialis rather than cutting through it. Nothing in the extensor mechanism is divided, patellar blood supply is preserved, and it ranks highest for early straight leg raise and early motion. It is the least extensile of the three and is harder in large, muscular or previously operated knees. I primarily use the subvastus approach. The honest answer patients deserve is this: recovery differences between approaches are real, and they are early. By six to twelve months, the literature stops separating them. What still separates outcomes is how well the operation is done. Serving Franklin, Brentwood, Nashville and Williamson County. #kneereplacement #subvastuskneereplacement #orthopedics This content is for educational purposes only and is not a substitute for professional medical advice.

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Friday 21 August 2026 17:41:07 GMT