Minimally Invasive Knee Surgery: The Subvastus Approach

Knee replacement surgery has come a long way in recent years. If chronic knee pain is putting a damper on your lifestyle, a minimally invasive option like the subvastus approach might be the solution you’re looking for. This technique offers a less disruptive path to regaining mobility and reducing pain.

Anatomy of the Knee

If you’re considering subvastus knee replacement, it helps to understand what’s happening in your knee. This joint connects your thigh bone (femur) to your shin bone (tibia), with your kneecap (patella) protecting the front. The ends of these bones are covered in cartilage, which helps them glide smoothly. Ligaments hold the bones together, and muscles around the knee—especially the quadriceps—allow you to move it.

In a healthy knee, everything works together in harmony. But when arthritis, injury, or wear and tear break down the cartilage or damage the joint, pain and stiffness may take over. That’s where knee replacement surgery comes in.

What Is the Subvastus Approach?

In a traditional knee replacement, surgeons cut through part of the quadriceps tendon to access the joint. As a major player in leg movement, cutting this tendon results in a longer, more painful recovery.

The subvastus approach works differently. Instead of cutting through the tendon, the surgeon goes underneath the vastus medialis muscle to reach the knee joint. This preserves the quadriceps mechanism, resulting in a muscle-sparing technique that’s less traumatic for your leg.

Benefits of the Subvastus Approach

This minimally invasive knee surgery offers several advantages over the traditional method:

• Less pain during recovery: Since the muscle isn’t cut, patients often report reduced soreness and less need for strong pain medication.
• Faster return to walking: Many people are up and moving carefully within hours of surgery.
• Improved strength and control: Preserving the quadriceps helps maintain knee stability and strength during recovery.
• Shorter hospital stay: Most patients are home the same day or within 24 hours of surgery.
• Less scarring: A smaller incision means a cleaner cosmetic result.

Preparing for Surgery

Proper preparation sets the tone for your entire recovery. Your surgeon will walk you through every step, which may include the following:

• Meet with your care team to review medications, medical history and anesthesia options.
• Engage in pre-op physical therapy to strengthen your leg muscles and make rehab easier.
• Set up your home so you can avoid the stairs and access the essentials.
• Review instructions on when to stop eating and which medications to stop ahead of surgery.

What the Procedure Involves

On surgery day, you’ll be taken to the operating room and given anesthesia. Depending on your comfort level, overall health, and the anticipated duration of the procedure, you may receive general anesthesia (making you completely unconscious) or spinal anesthesia (numbing you from the waist down).

The whole procedure typically takes one to two hours. Here’s how it unfolds:

1. The surgeon makes a small incision, usually around 4 to 6 inches, over the front of the knee.
2. The surgeon gently lifts and works beneath the vastus medialis to access the knee joint while sparing the muscle.
3. Damaged cartilage and bone are removed, and the surfaces are reshaped.
4. A metal-and-plastic knee implant is positioned to mimic natural joint movement.
5. The incision is closed, and you’re relocated to a recovery area.

Post-Op Care and Recovery

The first thing most patients ask is, “How long does it take to recover from knee replacement?” The subvastus approach speeds things up, but everyone’s recovery is a little different. Your surgeon will tailor your recovery plan to your health and goals, answering any questions or concerns that come up along the way.

The first few days of knee replacement recovery​ involve walking gently to prevent stiffness, promote circulation, and build strength. You will start home physical therapy the next day with an at home physical therapist and continue with a rehabilitation program for a few months.

Within four to six weeks, you can return to basic activities like walking, driving (once cleared), and climbing stairs. Expect to continue outpatient physical therapy based on your surgeons preferemce.

After three to six months, you’ll notice significant strength and stamina returning to your knee. By now, you can resume most low-impact exercises and hobbies. Some patients feel nearly back to normal, while others need a little more time.

Risks and Complications

Even with minimally invasive techniques, no knee replacement​ surgery is risk-free. Your surgeon may review the following risks with you:

• Infection
• Blood clots
• Implant loosening or wearing out over time
• Knee stiffness or reduced range of motion
• Nerve or blood vessel injury

Fortunately, these complications are rare, especially when surgery is performed by experienced fellowship trained surgeons. Pursue follow-up care and adhere to your rehab plan to minimize long-term problems.

Why Choose Forté Sports Medicine and Orthopedics?

Working with the right care team makes all the difference in your outcome. Forté Sports Medicine and Orthopedics has spent over 40 years helping people move better, feel better and live better. Our patients undergo joint replacement surgery with a clear treatment and recovery plan in mind, giving them complete confidence in our evidence-based practices. If you’re in Carmel, Greenwood, Noblesville, Mooresville or Tipton, IN, our team is ready to help you achieve a healthier, pain-free life. Request an appointment today at the location that works best for you.