title: [The mini-midvastus approach for total knee arthroplasty].
abstract: OBJECTIVE
  Minimally invasive approach to the knee for total knee arthroplasty to reduce soft-tissue trauma.
  
  
  METHODS
  Total knee replacements. Revision surgery after total knee arthroplasty.
  
  
  METHODS
  Severe obesity. Revision surgery with preoperative flexion<90 degrees.
  
  
  METHODS
  Anterior midline incision, blunt separation of the distal part of the oblique fibers of the vastus medialis over a length of 1-3 cm. The muscle split ends at the proximal medial corner of the patella. The incision is continued medially of the patella ending at the tibial tuberosity. After approaching the joint, the patella is shifted laterally without dislocating it, thus exposing the articular surfaces. Surgery is performed in maximal knee flexion of 90 degrees . After insertion of the components, stepwise wound closure and only superficial adaptation of the muscle split.
  
  
  METHODS
  Mobilization with weight bearing and range of motion as tolerated.
  
  
  RESULTS
  In a prospective study, 267 knee prostheses were implanted between 2005 and 2007 using the mini-midvastus approach. All patients (160 female, 107 male, average age 69.3 years [46-89 years]) were examined clinically and radiologically prior to and 6 weeks after surgery. The clinical results were based on the American Knee Society Score, which increased from a preoperative value of 48.9 (32-68) to 86.5 (75-100) at follow-up. Radiologically, 92.1% of the knees showed a malposition<3 degrees.
authors.affiliation: OCM-Klinik, Steinerstrasse 6, 81369, Munich. robert.hube@ocm-muenchen.de
authors.forename: Robert
authors.initials: R
authors.lastname: Hube
authors.forename: Manuel
authors.initials: M
authors.lastname: Keim
authors.forename: Hermann Otto
authors.initials: HO
authors.lastname: Mayr