A Gentle, Muscle-Sparing Option

When knee arthritis makes walking, climbing stairs, or enjoying daily activities painful, total knee replacement (TKR) can restore comfort and mobility. One technique, called the subvastus approach, is a muscle-sparing approach to the knee designed to minimize trauma to the quadriceps muscle, which plays a major role in knee extension and mobility. 

 

How the Subvastus Approach Works

In a traditional total knee replacement, the quadriceps tendon is partially incised to expose the knee joint. With the subvastus approach, the surgeon works beneath the vastus medialis muscle, gently moving it aside rather than cutting it.

This technique allows the knee joint to be replaced while keeping the quadriceps muscle intact, which plays a critical role in knee strength, stability, and function.

 

 

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Key Benefits for Patients

• Less Pain After Surgery –Studies indicate improved early post operative pain control in comparison to other approaches.

• Faster Recovery – Many patients regain movement and Quadriceps strength more quickly.

• Natural Knee Motion – Helps maintain smooth patella tracking (kneecap movement).

• Less post-operative pain: Less disruption to muscle tissue leads to lower pain scores post-op.

 

Things to Know

The subvastus approach isn’t right for everyone. Patients with very stiff knees, severe deformity, or certain medical conditions may do better with a different technique. Dr. Cone will guide you to the best option for your individual needs.

 

Bottom Line

The subvastus approach offers a muscle-sparing path to knee replacement, often leading to quicker recovery and excellent long-term results. Talk with Dr. Cone to see if this approach is a good fit for you.

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Available Evidence

1. Hofmann, A. A., Plaster, R. L., & Murdock, L. E. (1991). Subvastus (southern) approach for primary total knee arthroplasty. Clinical Orthopaedics and Related Research, (269), 70–77.

2. Keating, E. M., Faris, P. M., Meding, J. B., & Ritter, M. A. (1999). Comparison of the midvastus muscle-splitting and subvastus approaches in total knee arthroplasty. Journal of Arthroplasty, 14(1), 29–32.

3. Matsueda, M., & Gustilo, R. B. (2000). Subvastus and parapatellar approaches in total knee arthroplasty. Clinical Orthopaedics and Related Research, (371), 161–168.

4. Teng, Y., Zhang, Y., Zhang, X., Xu, Y., & Zhang, W. (2012). Subvastus versus medial parapatellar approach in total knee arthroplasty: A meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research, 7(1), 42.

5. Weinhardt, C., Barisic, M., & Bergmann, E. G. (2004). Early functional results with the subvastus approach in total knee arthroplasty: A prospective, randomized study. Archives of Orthopaedic and Trauma Surgery, 124(6), 401–403.