Successful total knee arthroplasty depends in part on reestablishment of normal lower extremity alignment, proper implant design and orientation, secure implant fixation, and adequate soft-tissue balancing and stability.
The operative technique for the standard total knee arthroplasty (TKA) involves a skin incision between 16 cm (6 in) and 30 cm (12 in). In comparison, when Dr. Luke Vaughan started talking about a "shorter incision" in 2000 for primary total knee arthroplasty, he suggested that 10 cm (4 in) was a good starting point and the incision could be extended if needed. Since that time, some surgeons are reporting that a skin incision for the MIS Quad-Sparing technique may be as short as 8 cm (3 in).
Total knee arthroplasty using a less invasive technique is suggested for non-obese patients with preoperative flexion greater than 90 degrees. Patients with varus deformities greater than 17 degrees or valgus deformities greater than 13 degrees are typically not candidates for a smaller incision technique.