Why Minimally Invasive Knee Replacement May Not Be For You


Contributor: Carlos Higuera, MD

If you’ve decided to have a total knee replacement, you might be considering a minimally invasive procedure. This type of surgery uses smaller incisions and less cutting of the tissue surrounding the knee. The advantage of such a surgery is that it allows for faster recovery, a shorter hospital stay and less blood loss.

But aside from these potential short-term advantages, there’s good reason to strongly consider a traditional surgery for a total knee replacement.

Be sure to talk it over with your doctor. While the minimally invasive approach is not for everyone, the risk of complications associated with a more complex operation may outweigh its benefits for you.

Whatever surgery you choose, evidence suggests that minimally invasive surgery is no more beneficial than traditional total knee replacement in the long term.

Traditional surgery

About 70 percent to 80 percent of total knee replacements are performed using the traditional approach.

Traditional total knee replacement entails cutting into the quadriceps tendon, which connects the large quadriceps muscle group on the front of the thigh to the kneecap. The surgeon then moves the kneecap out of the way to access the arthritic joint.

The larger incision gives the surgeon a wide enough view to properly align the implant and bone. This is important because precise alignment is key to ensuring durability and a long life for the implant.

Newer minimally invasive knee replacements avoid the quadriceps tendon. Instead, the surgeon works through an incision in a muscle in the quadriceps.

Much of the power of your knee comes from the quadriceps. When this muscle and tendon group is cut out, as in traditional knee replacement, the repair and recovery may require a longer hospital stay and physical therapy.

Otherwise, there’s no difference between minimally invasive and traditional knee replacement in terms of physical therapy, pain, walking speed and other measures of function during the recovery period.

Minimally invasive surgery

The minimally invasive approach may not be appropriate for heavy-set or very muscular patients, those with severe knee instability or deformity, or those who require a more complex replacement.

Other aspects to consider:

What you can do

The first thing to do is get options from a surgeon who does minimally invasive total knee replacement and one who does only traditional surgery, and weigh the pros and cons of each.

After your decision:

More information

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