The Low Mini-Midvastus Approach for Minimally Invasive Total Knee Arthroplasty

The low mini-midvastus approach is a refinement of minimally invasive techniques in total knee arthroplasty (TKA). This technique involves making a precise muscle-splitting incision along the vastus medialis obliquus, retaining a 1-cm wide inferomedial cuff of the muscle belly, preserving the extensor mechanism while maintaining sufficient surgical exposure. We hypothesize that the low mini-midvastus approach minimizes postoperative pain, accelerates recovery, and enhances patient satisfaction by optimizing vastus medialis obliquus integrity. It is suitable for primary TKA and adaptable to challenging anatomical variations. In this study, we describe our surgical technique and experience with such an approach for conventional primary TKA that represents a refinement of the midvastus spectrum that prioritizes muscle preservation while maintaining adequate exposure. (c) 2025 The Authors. Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/ 4.0/).