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.
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.
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.
This minimally invasive knee surgery offers several advantages over the traditional method:
Proper preparation sets the tone for your entire recovery. Your surgeon will walk you through every step, which may include the following:
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:
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.
Even with minimally invasive techniques, no knee replacement surgery is risk-free. Your surgeon may review the following risks with you:
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.
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.
Dr. Joseph Maratt, Forté Sports Medicine and Orthopedics hip and knee replacement surgeon, has advanced training in hip replacement, knee replacement and robotics in joint replacement. An early adopter of robotic surgery over a decade ago, he has been involved in the development of robotic and navigation systems to improve patient care. He is a pioneer in the use of muscle-sparing approaches with robotic knee replacement and has taught surgeons across the country in the use of these techniques.
The Subvastus Approach: A Smarter Approach to Total Knee Arthroplasty (TKA) If you’re considering knee replacement, you’re likely focused on one thing: getting back to your life with as little pain and recovery time as possible. At Forté Sports Medicine and Orthopedics, Dr. Joseph Maratt offers muscle–sparing surgical technique – the subvastus approach. When paired with advanced tools like robotic assistance and kinematic alignment, it represents the next generation of personalized knee replacement care.
An Overview of the Subvastus Approach
Knee replacement is typically done through a medial parapatellar approach or a midvastus approach. These approaches cut either the quad tendon or the vastus medialis muscle, respectively. The subvastus approach, however, avoids cutting either of these by entering the joint medially and under the entire quad muscle. This muscle-sparing approach causes less trauma and pain in the early period following surgery. The early period, as it turns out, is not just a matter of a couple of weeks of benefits. The early period being better sets the stage for the months of recovery that follow.
How Does the Subvastus Approach Differ from Traditional Knee Replacement Techniques?
The primary difference of the subvastus approach to a knee replacement is that it is muscle sparing. When combined with a torniquet-free, robotic, kinematic approach for total knee replacement, this technique provides patients with the least amount of tissue (less ischemia from tourniquet, less releases of tissue to balance knee) and muscle damage possible during a total knee arthroplasty. All these choices together, along with our prep and recovery pathway, make this knee replacement approach better than previous options.
Am I a Good Candidate for the Subvastus Approach?
While 99% of patients can have a total knee arthroplasty with the subvastus approach, it is best to decide together with a physician on the approach that is best for you.
What is the Recovery Time for the Subvastus Approach?
Patients typically stand and walk on the day of surgery, and off assistive devices within a few days. Patients will see marked improvements within a few weeks and be back to almost all activities by three months postoperatively. Patients will feel better as recovery progresses, but we advise not to overdo it.
What Are the Risks of the Subvastus Approach?
This surgery is done through a smaller, less invasive approach, compared to other approaches to knee replacement. It requires more skill and specialized tools to minimize the risk.
Is Recovery Less Painful with the Subvastus Approach?
Yes, studies have shown patients who have total knee arthroplasty with the subvastus approach have a less painful recovery. Our patients also take significantly fewer opioid pills after the subvastus approach than with the medial parapatellar approach to total knee arthroplasty.
Contact Forté Sports Medicine and Orthopedics
Forté Sports Medicine and Orthopedics provides exceptional care tailored to our patients’ needs. With over 40 years of experience, our team of providers and clinicians know the importance of putting patients first. When you meet with Dr. Joseph Maratt to discuss your knee pain concerns, expect to leave with a detailed action plan in hand. Our flexibility and comprehensive services mean you can see a physician, get diagnostic imaging, and start treatment all in one convenient location. If you’re considering knee replacement, contact us to request an appointment. We’ll help you take the next step toward a pain-free life.
In the mid-90s, a group of more than 27,000 Swedish patients who had knee replacement surgery received a postcard in the mail asking one question: Are you satisfied with the outcome?
When an overwhelming 83% of respondents said “yes,” researchers spent the next two decades focused on the remaining 17%.
“What they found is that these patients say something just feels different,” says Dr. Joseph Maratt, knee replacement surgeon at Forté Sports Medicine and Orthopedics. “Because of that, there is greater awareness that every knee is slightly different, and one of the best ways to change the outcome for that 17% is to personalize knee replacement based on each person’s anatomy.”
Computer-assisted knee replacement, also known as robotic knee surgery, utilizes advanced technology to enhance the precision and personalization of knee replacement procedures. Integrating computer systems and robotic arms allows surgeons to plan and execute surgeries with greater accuracy for improved patient outcomes.
At Forté, patients receive computer-assisted knee replacements, which are more personalized than traditional knee replacement surgeries.
The first step is patient-specific surgical planning. A CT scan of your knee is used to create a 3D virtual model of your unique joint. After tracking a series of points around your knee, Dr. Maratt guides it through a range of motion to capture how much it will straighten, how far it can bend, and how tight the ligaments are.
“What we often see is that if we just decided to put implants in based on the 3D model alone, you’d end up with a knee that feels too tight when you’re trying to bend it,” says Dr. Maratt. “Those are the things that, in the past, would make recovery really hard.”
Dr. Maratt uses the model to determine the optimal size, placement, and alignment of your implant. With help from the computer guidance system, he can optimize where bone cuts should be and where implants will go so that ligaments are ideally tensioned.
“Think of it as a simulation tool that we can use to try different combinations of things and pick the one that makes the most sense before we make a single bone cut,” he says.
After adjusting the software, Dr. Maratt uses robotic arm technology to help perform the knee replacement. “It ultimately leads to less pain in the post-op period,” says Dr. Maratt. “We can’t make a knee replacement painless, but it leads to a more normal feeling knee and a faster recovery.”
Robotic techniques provide numerous benefits over traditional knee replacement surgery, including:
With the implant in place, you’ll begin your journey to strengthen your new joint. Rehabilitation begins immediately. Within 24 hours of your surgery, your physical therapist will help you stand and walk with an assistive device like a walker, a cane, or crutches. You’ll receive instructions for safely getting in and out of bed so you can move around relatively independently.
Expect to be discharged from the hospital one to three days after surgery. The timeframe depends on your overall health and how well you’re healing. At this point, you should start feeling stronger and taking lower doses of pain medication.
Your physical therapist will give you several exercises to do at home and visit you a few times in the first two weeks. Perform the exercises as directed to help you heal properly and regain maximum mobility and flexibility in your knee.
Just as every knee is different, so is every patient’s experience. But Dr. Maratt says most patients hit a series of milestones as they participate in physical therapy following computer-assisted knee replacement surgery:
Determining your readiness for knee replacement surgery is a personal decision. While Dr. Maratt says he can help you understand when surgery is appropriate for your situation, only you can decide when the time is right.
“My advice is to take note if you’re unhappy with the choices you’re making, such as choosing to sit in your hotel room rather than going sightseeing with your family,” says Dr. Maratt.
“When you get to that point, don’t become sedentary,” he says. “Get back to the things in life that you like doing.”
Forté Sports Medicine and Orthopedics provides exceptional care tailored to your needs. With over 40 years of experience, we know the importance of putting patients first. When you visit us with knee pain concerns, expect to meet with one of our doctors and leave with a detailed action plan in hand. Our flexibility and comprehensive services mean you can see a physician, get diagnostic imaging, and start treatment all in one convenient location. If you’re considering computer-assisted knee replacement, contact us to request an appointment at one of our locations in Carmel, Greenwood, Noblesville, or Tipton, IN. We’ll help you take the next step toward a pain-free life.
Total knee replacement is the most common joint replacement procedure performed today, with a large majority of patients reporting near or complete relief of their arthritic symptoms after recovering from surgery.
Knee replacement is best described as knee resurfacing, with the end of the femur and the top of the tibia resurfaced with smooth metal and plastic implants. It’s a good option when severe knee arthritis causes daily pain and limitations that non-operative treatments don’t resolve.
While reliable in its effectiveness, there are still a number of factors to consider to ensure the best possible outcome. Below, we look at some difference makers in knee replacement surgery.
Appropriateness
Appropriateness is a leading factor in how effective knee replacement surgery will be. There are many non-operative care options for arthritis patients, and the decision to have knee replacement surgery is most often a “quality of life” choice. Surgery may be appropriate if a patient has tried exercise, medications, physical therapy or bracing and is still experiencing daily pain and limited joint function.
Preparation
While knee replacement surgery may be appropriate for your situation, it can still take a toll on your physical and mental health. For the best possible outcome, preparation for knee replacement surgery should include a prehabilitation or prehab program to help make you stronger going into the procedure.
A prehab program that includes education and strengthening exercises can optimize where you are in your musculoskeletal health and help identify any medical problems that could impact your recovery.
Experience and Volume
It may go without saying, but experience and volume also impact the effectiveness of knee replacement surgery. Evidence suggests that selecting a surgeon who does at least 50 to 100 replacements a year and a hospital that does at least 100 a year improves your chances of an ideal outcome.
Computer-Assisted Knee Replacement
Advancements in surgical techniques and technologies also lead to an increase in patient satisfaction with knee replacement surgery.
Computer-assisted navigation systems allow surgeons to plan surgery on a 3D model of a patient that’s developed from a CT scan. A robotic arm then assists the surgeon in making pre-planned bone cuts that allow for a greater degree of accuracy.
“Because of technology like this, there’s greater awareness of the fact that every knee is slightly different,” says Dr. Joseph Maratt, knee replacement surgeon at Forté. “The solution is to personalize the positioning of implants based on each person’s anatomy.”
Personalized Knee Replacement
A more personalized knee replacement process enhances patient outcomes because it ensures the surgeon removes just the right amount of damaged material during surgery. More of a patient’s soft tissues and bone are preserved, and there is increased accuracy in implant positioning, reducing the risk of complications.
“Personalization ultimately leads to less pain in the post-op period,” says Maratt. “We can’t make a knee replacement painless, but it leads to a more normal feeling knee and a faster recovery.”
Learn More
Wondering what to expect from life after knee replacement surgery? Maratt answers some of the most frequently asked questions and shares some of the benefits of computer-assisted knee replacement surgery.
To learn more about Forte’s joint replacement offerings using the latest techniques and technologies for the best results and fastest recovery, visit forteortho.com or call 317.817.1200.
Knee replacement surgery can be life-changing for people who have spent years dealing with chronic knee pain, stiffness and limited mobility. Many patients come to our team at Forté with one big question: “What will life look like after surgery?”
The good news is that most patients return to many of the activities they enjoy after a successful knee replacement and a dedicated recovery process. From playing pickleball and traveling to navigating airport security, understanding what to expect can help you set realistic goals and feel confident about your recovery journey.
If you are researching knee replacement near me, this guide explains what happens after surgery, how recovery typically progresses, and when you may be able to return to everyday activities.
Recovery after knee replacement surgery does not happen overnight. Your body needs time to heal, rebuild strength and adapt to the new joint. Every patient progresses at a different pace based on factors such as age, overall health, activity level and commitment to physical therapy.
Most patients begin moving their new knee shortly after surgery. Early movement helps improve circulation, reduce stiffness, and support long-term function. During the first few weeks, physical therapy plays a critical role in restoring motion and strength.
Many patients experience the following recovery milestones:
At Forté Sports Medicine and Orthopedics, we work closely with patients throughout the recovery process to help them achieve the best possible outcome and safely return to the activities they enjoy.
One of the most common concerns patients have, is knowing when they can safely return to their normal routines. While healing timelines vary, many everyday activities become easier as strength and mobility improve. Patients can often return to:
Successful recovery extends beyond the operating room. Ongoing support from experienced providers can make a significant difference in long-term outcomes. Our sports medicine physicians understand the unique physical demands that activities place on the body. While many people associate sports medicine services with athletes, these specialists also help everyday patients regain function, improve movement, and return to activities they enjoy. The benefits of working with a sports medicine team may include:
Travel is another topic that frequently comes up during recovery discussions. Many patients look forward to visiting family, taking vacations or returning to work-related travel after surgery. Traveling too soon after knee replacement can increase discomfort and may raise concerns about blood clots, especially during long periods of sitting. Your surgeon will recommend an appropriate timeline based on your health and recovery progress. When traveling after knee replacement surgery, consider these tips:
One of the most searched questions among knee replacement patients is: Will my knee replacement set off airport security? The answer is yes; it is possible.
Many artificial knee implants contain metal components that may trigger metal detectors or other airport screening technology. Security procedures continue to evolve, so experiences can vary from one airport to another. If airport security identifies your implant, you may undergo additional screening. Transportation Security Administration personnel are familiar with joint replacement implants and regularly assist travelers who have undergone orthopedic procedures. Patients often ask if they need a special card or an implant identification document. While some manufacturers provide implant information, security personnel generally rely on the screening process rather than identification cards.
When preparing for air travel:
Modern knee replacement procedures have helped millions of people achieve meaningful improvements in quality of life. Many patients experience reduced pain, increased mobility, and greater confidence in daily movement. Long-term success depends on several factors, including:
Many patients notice major improvements within the first few months. Full recovery and continued strengthening may take up to a year.
Many patients return to recreational activities after knee replacement. Your surgeon can help determine which sports are appropriate based on your health, recovery progress, and individual goals.
Knee replacements are designed to be durable, but no implant lasts forever. Many modern knee replacements continue functioning well for many years when patients follow their physician's recommendations and maintain a healthy lifestyle.
Not always. Some implants trigger screening equipment while others may not. Additional screening is normal, and airport personnel regularly work with travelers who have joint replacements.
Living with knee pain can make even simple activities feel challenging. Knee replacement surgery may help restore mobility and allow you to return to the hobbies, travel plans and daily routines that matter most. At Forté Sports Medicine, we are committed to helping patients achieve lasting results through expert orthopedic care, advanced treatment options and comprehensive recovery guidance. If you are searching for knee replacement near me or want to learn more about our joint replacement services, our experienced team is here to help you take the next step toward a more active future. Request an appointment with us today!
When Tony Sandlin started feeling side and back pain getting in and out of his hot air balloon baskets, he knew something was wrong.
Tony has been a hot air balloon hobbyist for nearly 20 years and 12 years ago, he decided to make Midwest Balloon Rides a full-time gig. He needed to be able to climb in and out and on top of the baskets to work on burners and when he started feeling pain, he called Forté on the recommendation of a friend.
Tony realized the pain he was feeling was actually hip pain, despite never having hip issues before. He met with Dr. Joseph Maratt, who determined that Tony needed his hip replaced.
The process went so smoothly, Tony asked Dr. Maratt if he really did the hip replacement – he was amazed at the lack of pain following the procedure. So when he determined that he needed his other hip replaced, he knew exactly where to go.
“I’ve been telling people, ‘Don’t be afraid of getting the hip done. Don’t wait until you’re 70 years old. You don’t have to – it’s not as bad as you think it’s going to be,’” said Tony.
Thanks to Dr. Maratt and the team at Forté, Tony is back in the sky and feeling better than ever.
Don't let joint pain stand in the way of what you love most. Our team is here to listen to you, and provide a quick diagnosis and personalized treatment plan to help you get back to living a full life. Request an appointment online or by phone at 317.817.1200.
CARMEL, Ind. (January 5, 2023): Forté Sports Medicine and Orthopedics, previously known as Methodist Sports Medicine, announces the election of a new board president and officers, effective as of Jan. 1, 2023. Dr. Jonathan Smerek now serves as president of the medical group, with Dr. Dale Snead serving as vice president and Dr. Joseph Maratt serving as secretary and treasurer.
Smerek, a fellowship-trained orthopedic surgeon specializing in foot and ankle reconstruction, brings vast experience to his new leadership role, including serving as a team physician in which he works as part of a highly collaborative group taking care of athletes. Before being elected president, Smerek served one term as vice president of Forté.
“I’m honored to have been selected to lead Forté and to keep building on all of the great achievements we’ve had during our 40 years of service to the community,” said Smerek. “I firmly believe that, like an athletic team, each member of a medical group contributes to the overall success of the organization. My main priority as president will be working with all team members to grow our practice and build out our centers of excellence in each specialty to continue to be a go-to for orthopedic care in Central Indiana and beyond.”
Smerek succeeds Dr. Mark Ritter, who served as Forté’s president for eight years and continues to serve the medical group as a physician. Ritter, one of three team physicians for the Indianapolis Colts, is a fellowship-trained orthopedic surgeon specializing in orthopedic sports medicine, trauma, and knee and shoulder injuries. During Ritter’s tenure as president, Forté underwent a rebranding process, opened both a new clinic and a new orthopedic specialty hospital in Carmel, advanced its urgent care program, and added two new surgeons, among other successes.
“Dr. Ritter’s support of Forté, its physicians and staff has been steadfast, requiring many hours outside of his patient schedule and family time,” said Marty Rosenberg, CEO of Forté. “We will be forever grateful for his leadership, which not only continued the legacy Forté has established as one of the country’s original sports medicine practices but also built upon it.”
To learn more about Forté Sports Medicine and Orthopedics, its services, and its accomplished team of physicians and staff, visit forteortho.com.
About Forté Sports Medicine and Orthopedics
Forté Sports Medicine and Orthopedics, previously known as Methodist Sports Medicine, is an independent, physician-owned orthopedic practice recognized as one of the region’s most respected orthopedic groups. Founded in 1983 as one of the country’s original sports medicine practices, Forté’s physicians and staff provide comprehensive, specialized sports medicine and orthopedic care to patients of all ages.
Clinical evaluations performed by highly skilled fellowship-trained orthopedic surgeons, combined with advanced surgical techniques and comprehensive non-surgical treatment options, provide patients with exceptional treatment outcomes and a return to active living. Forté provides patients with expert orthopedic care in several sub-specialties, including hand, wrist, elbow and shoulder; foot and ankle; hip and knee; joint replacement and revision; spine care and sports medicine. Forté has been trusted by the Indianapolis Colts as their official team physicians since 1983 and serve as the orthopedic provider for Purdue University, Butler University, Indiana State University and numerous high schools and public safety departments throughout central Indiana.
Forté Sports Medicine and Orthopedics also innovates daily through a separate 501(c)(3), Forté Orthopedic Research Institute, that improves the lives of patients everywhere through advanced clinical research and education.
Dr. Joseph Maratt, joint replacement surgeon with Forté Sports Medicine and Orthopedics, said the Stryker Mako technology combines advanced navigation for preoperative planning with a robotic arm that allows the surgeon to precisely execute the plan.
Preparing for joint replacement surgery can feel overwhelming, especially when it comes to understanding recovery timelines, mobility limitations, and necessary at-home care. Pre-operative education helps patients feel confident and empowered by ensuring they know exactly what to expect both before and after their procedure. By addressing patient anxiety and providing a clear roadmap for the weeks ahead, this specialized preparation is a cornerstone of achieving better surgical outcomes and a smoother transition back to daily life. Forté Sports Medicine and Orthopedics explains why one-on-one pre-op education is crucial for joint replacement patients.
Pre-operative education for joint replacement is a comprehensive planning process designed to optimize a patient’s physical and mental readiness for surgery. Rather than a generic pamphlet, this education involves a personalized session where patients learn about their specific surgical plan, home modification needs, and the importance of a dedicated support system. At Forté Sports Medicine and Orthopedics, we focus on individualized goals, whether that means returning to a favorite sport or simply walking without pain, ensuring that your caregivers are just as prepared as you are for the journey ahead.
Extensive research suggests that well-informed patients experience lower levels of post-surgical anxiety and higher satisfaction rates. When you understand the "why" behind your recovery steps, you are better equipped to manage pain effectively and more likely to adhere to essential physical therapy protocols. By establishing realistic expectations for mobility and discomfort early on, pre-op education sets the stage for a faster, more predictable recovery period, reducing the likelihood of complications or hospital readmissions.
During a one-on-one session, our specialists dive into the practicalities of your recovery. This isn't just a lecture. It is hands-on training tailored to your unique environment. The key topics include:
Successful preparation starts weeks before you enter the operating room. To ensure the best results, patients should prioritize several key areas:
The days following surgery are focused on managing pain and regaining mobility. While some discomfort is expected, our orthopedic doctors utilize advanced techniques to keep you comfortable. You can expect to begin light movement and physical therapy almost immediately, as gradual weight-bearing helps prevent stiffness. Understanding this timeline, from the initial inflammatory phase to the long-term strengthening phase, helps you stay motivated during the challenging early weeks of rehabilitation.
Preparing for joint replacement is just as important as the surgery itself. Our team provides personalized, one-on-one education to help you feel confident every step of the way. While every patient benefits from preparation, certain individuals find it particularly transformative.
First-time surgery patients often experience the highest level of uncertainty and benefit from demystifying the process. Similarly, older adults or patients who live alone find the safety and fall-prevention training crucial for maintaining independence. Regardless of your age or activity level, personalized education ensures that your specific concerns are addressed by experts who specialize in joint health and recovery.
It reduces patient anxiety, aligns expectations and provides the practical skills needed to navigate recovery safely, leading to better overall outcomes.
Focus on home safety, arranging for a caregiver, and attending a pre-operative education session to learn about your specific recovery exercises.
It encourages early mobilization and better adherence to physical therapy, which are critical factors in regaining full range of motion and strength.
Commonly needed items include a front-wheeled walker, single point cane, a raised toilet seat, and specialized ice packs, all of which are discussed during your pre-op session.
Forté Sports Medicine and Orthopedics is an integrated orthopedic practice that offers the area’s most experienced joint replacement surgeons, in-office physical therapy, and interventional pain management. Our facilities are in Carmel, Greenwood, Mooresville, Noblesville, and Tipton, IN. Contact us today to speak with our orthopedic coordination team.
Our Tipton office will be closed Monday, October 19th - Wednesday, October 21st.