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New Technology: Minimally Invasive Knee Replacement

Muscle Sparing (or MIS) Knee Joint Replacement with Surgical (Computer) Navigation

Muscle Sparing Knee Joint Replacement is considered a great step forward in total knee replacement for a number of reasons, which may include the following: faster recovery, a shorter hospital stay, and possibly less scarring and less disruption of the muscle tissue.

Minimally Invasive Surgery

During the last several years, minimally invasive surgery has revolutionized many fields of medicine. One of the characteristics is that it uses specialized techniques and instrumentation that enable the physician to perform major surgery without the larger, more traditional, incision. In this respect, Muscle Sparing Technique (MST) Knee Joint Replacement is indeed “minimally invasive” and muscle sparing, requiring a somewhat smaller incision and causing the least amount of trauma to the soft-tissues. In many cases the muscle sparing techniques have shortened recovery time or return to “normal” activities. This has been one of the primary objectives of the move toward less invasive types of surgery. Some secondary benefits have also been gained by reducing time required in the hospital. Unlike the original or older style of total knee replacement—which requires a large incision (8 to 12 inches) and greater disruption of the muscles and tendons—MST Knee Joint Replacement can be performed through an incision as small as 4 to 6 inches. In the MST procedure the amount of soft tissue (muscles and tendons, etc.) that are disrupted during surgery is reduced. Through that same smaller incision, the diseased surfaces of the knee joint are exposed and then replaced, one at a time, with the artificial joint components. The addition of computer navigation is now assisting surgeons in improving the alignment of Total Knee Replacements so that they last longer, wear less, and work better.

Listing the Advantages Muscle Sparing Techniques

When fewer muscles and tendons are disturbed with MST Knee Joint Replacement, their reconstruction is more natural, wound closure is more accurate, and recovery may be faster1. Clinical studies have shown that the subvastus surgical approach used in the MST technique results in less pain (at both 8 days and 6 weeks after surgery) and quicker restoration of muscle control and strength2. Even though it can still take several months for all of the healing of a joint replacement to occur these techniques make getting back to “normal” activities more rapid.

Benefits of Surgical (Computer) Navigation

The addition of surgical navigation has also helped in the advancement of Total Knee Replacement. When using this, the surgeon is able to align the knee replacement along the best mechanical axis or line to allow the best motion and the least amount of wear on the knee parts. This also helps by allowing the surgeon to set this alignment without having to violate the medullary canal (marrow space) in the leg bones. This may help to reduce the risk of post surgical complications with the heart and lungs. While studies are ongoing with regard to computer navigation the early results are very promising.

Risks Associated with Muscle Sparing Total Joint Replacement Surgery

The MST Knee Joint Replacement technique is less invasive than conventional TKR, but it is still a total knee replacement. It takes little additional time to complete and may result in advantages for the patient. Joint replacement surgery is a major surgery and significant complications, while uncommon, can occur.

As with any major surgical procedure, patients who undergo total joint replacement are at risk for certain complications, the vast majority of which can be successfully avoided and/or treated. In fact, the complication rate following joint replacement surgery is very low: Serious complications, such as joint infection, occur in less than 1-2% of patients. (Besides infection, possible complications include blood clots and lung congestion, pneumonia, and other medical problems or complications associated with the knee replacement itself.)


  1. 1. White R, Allman J, Trauger J, Dales, B. Clinical Comparison of the Midvastus and Medial Parapatellar Surgical Approaches. Clinical Orthopaedics & Related Research. 1999; 367: 117-122.
  2. 2. Tria AJ. Minimal Incision Total Knee Arthroplasty. Clinical Orthopaedics & Related Research. 2003; 416: 185-190.