← Surgical approaches

The reference library

Three approaches.
The published evidence.

802 references on medial parapatellar, subvastus, and midvastus approaches, including related techniques. Compiled from PubMed/MEDLINE on September 11, 2026.

A broad bibliography, not 802 comparative trials. The key reviews below support the patient summary. Article links open at their original source; full-text access depends on the publisher.

Start with these reviews

  1. Berstock et al., 2018

    Subvastus: earlier straight-leg raise, less day-one pain, more week-one motion, and longer operating time.

  2. Alcelik et al., 2012

    Midvastus: approximately 9° more flexion in the first week in pooled trials.

  3. Xu et al., 2014

    Mini-midvastus: early benefits diminish; later scores, motion, and complications were generally comparable.

  4. Rainey et al., 2026

    Across 27 randomized trials, no approach consistently outperformed the others for motion, patient-reported outcomes, or reoperation rates.

  5. Vaishya et al., 2016

    Anatomy, exposure, patient selection, and the importance of the surgeon’s training and experience.

802 articles

1. Comparative studies (two or more of the three approaches)

  1. Erdem AC, Erdem M, Turgut N, Bayam L, Sağlam F, Serttaş MF. Is the Mini-Midvastus Approach for Total Knee Arthroplasty Any Better in Reducing Blood Loss and Hospital Stay?. J Knee Surg. 2026;39(11):567-574. PMID 41760101.

    PubMed · DOI

    midvastus · medial parapatellar · Subscription / not open access

  2. Fan Y, Jiang L, Chen Z, Wang C. Comparison of robot-assisted modified subvastus approach versus medial parapatellar approach in total knee arthroplasty: a retrospective cohort study. J Orthop Surg Res. 2026;21(1):81. PMID 41484636.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Comparative Study · Open access

  3. Gürbüz S, Pehlivanoğlu G, İğde N, Keskin A, Ayaz MB, Karslıoğlu B. Comparison of Subvastus and Medial Parapatellar Approaches in Total Knee Arthroplasty for Patients Aged Over 75 Years: Implications for Postoperative Rehabilitation and Early Mobilization. Med Sci Monit. 2026;32:e952375. PMID 42141711.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Comparative Study · Open access

  4. Huh MH, Kim HJ, Shin YS. Comparison of conventional and minimally invasive approaches of primary total knee arthroplasty: a network meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2026;27(1):. PMID 41807933.

    PubMed · DOI · PMC

    subvastus · midvastus · Network Meta-Analysis; Comparative Study; Systematic Review · Open access

  5. Mylonas V, Grigoriadis S, Metaxiotis D, Kellis E, Stergiou N, Nikodelis T. Medial parapatellar surgical approach leads to greater loss of postural sway complexity compared to mid-vastus approach in women undergoing total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2026;34(5):1700-1712. PMID 40923336.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Randomized Controlled Trial; Comparative Study · Open access

  6. Rainey JP, Radtke LE, Gililland JM, Mont MA. The Influence of Total Knee Arthroplasty Surgical Approach on Range of Motion, Patient-Reported Outcome Measures, and Reoperation Rates: A Systematic Review of Randomized Controlled Trials. J Arthroplasty. 2026;41(8):2548-2555. PMID 41240972.

    PubMed · DOI

    subvastus · midvastus · medial parapatellar · Systematic Review · Subscription / not open access

  7. Shah P, Singh R, Shanwal PK, Yadav DK, Jain R. Comparing the Subvastus and Medial Parapatellar Approaches in Total Knee Arthroplasty. J Orthop Case Rep. 2026;16(4):346-350. PMID 41970725.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  8. DeFrancisis JS, Munro R, Danahy P, Farmer ME. Comparison of Postoperative Outcomes Following Medial Parapatellar Versus Medial Subvastus Approaches for Total Knee Arthroplasty in a Single Patient: A Case Report. Cureus. 2025;17(7):e88843. PMID 40881534.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Case Reports · Open access

  9. Gounot A, Dardenne G, Dehaine B, Burdin V, Decrouez M. Patient-Specific Prediction of Total Knee Arthroplasty Surgical Exposure Using a Statistical Shape Model Augmented with Clinical Dataset. Annu Int Conf IEEE Eng Med Biol Soc. 2025;2025:1-7. PMID 41336671.

    PubMed · DOI · Open-access link

    subvastus · midvastus · medial parapatellar · Open access

  10. Gupta G, Gupta AR, Aggarwal S, Raghuraj A. A comparative study between Sub-vastus and medial parapatellar approaches in total knee arthroplasty: A prospective study. J Clin Orthop Trauma. 2025;70:103209. PMID 41049718.

    PubMed · DOI · PMC · Open-access link

    subvastus · medial parapatellar · Open access

  11. Hinkley JR, Nedopil AJ, Berend KR. An Insert Goniometer Identifies One Insert Thickness That Provides Maximum Tibial Rotation During Kinematically Aligned TKA Using a Medial Parapatellar Approach. Surg Technol Int. 2025;45:. PMID 39946751.

    PubMed

    midvastus · medial parapatellar · Subscription / not open access

  12. Hu W, Nie Y, Li Y, Yang B, Su Z, Zhu Z, et al.. A modified minimally invasive subvastus approach shows superior early postoperative clinical outcomes compared to the medial parapatellar approach in total knee arthroplasty for osteoarthritis patients: a comparative study. BMC Musculoskelet Disord. 2025;26(1):1117. PMID 41422212.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Comparative Study · Open access

  13. Jamal R, Shaqroon HA. Total Knee Revision Using the Midvastus Approach: A Case Report. Cureus. 2025;17(5):e83945. PMID 40357318.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Case Reports · Open access

  14. MacLeod JS, Hershey M, Sherman KA, Lee MS, McKenzie C, Kukushliev VV, et al.. Perioperative outcomes of the quadriceps-sparing subvastus approach versus medial parapatellar approach for primary total knee arthroplasty. J Orthop. 2025;70:208-214. PMID 40895354.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Subscription / not open access

  15. Prashanth BN, Sangani K, Reddy YM. Robot-assisted total knee arthroplasty using modified sub-vastus approach: A series of 120 knees. J Clin Orthop Trauma. 2025;68:103078. PMID 40524732.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  16. Quah ESH, Chee BRK, Thwin L, Yam MGJ. Comparing early functional outcomes between the midvastus and medial parapatellar approach for total knee arthroplasty: A prospective cohort study in an Asian population. J Clin Orthop Trauma. 2025;67:103033. PMID 40771995.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Open access

  17. Silva RRD, Matos MA, Badaró DA, Prata PB, Ariel de Lima D. A Comparative Study of the Medial Parapatellar and Midvastus Surgical Approaches for Total Knee Arthroplasty. Rev Bras Ortop (Sao Paulo). 2025;60(1):s00441800945. PMID 40041749.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Open access

  18. Aladraii AA, Allehaibi LZ, Fattani AA, Alkhudairy TA, Al-Margan AM, Al-Dubai SAR, et al.. Functional Outcome of Subvastus versus Medial Parapatellar Approaches for Total Knee Replacement in Patients with Knee Osteoarthritis: A Prospective Cohort Study. Saudi J Med Med Sci. 2024;12(1):35-39. PMID 38362087.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  19. Güven MF, Özer M, Özşahin MK, Değer GU, Adaletli İ, Aykan Kargin O, et al.. Comparison of early outcomes of primary total knee arthroplasties performed using subvastus and medial parapatellar approaches and evaluation of quadriceps muscle elastography. Arch Orthop Trauma Surg. 2024;144(11):4839-4847. PMID 39311941.

    PubMed · DOI

    subvastus · medial parapatellar · Comparative Study · Subscription / not open access

  20. Hosseini-Monfared P, Mirahmadi A, Amiri S, Minaie R, Ghafouri MH, Kazemi SM. Comparable long-term functional outcomes of subvastus and medial parapatellar approach in total knee arthroplasty: A 10-year follow-up study. J Exp Orthop. 2024;11(4):e70035. PMID 39380847.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  21. Nikodelis T, Grigoriadis S, Metaxiotis D, Mylonas V, Kellis E. Mid-vastus approach induces milder short-term effects on postural control compared to parapatellar approach in total knee arthroplasty. Clin Biomech (Bristol). 2024;120:106354. PMID 39326067.

    PubMed · DOI

    midvastus · medial parapatellar · Randomized Controlled Trial; Comparative Study · Subscription / not open access

  22. Sidhu SP, Broberg JS, Willing R, Teeter MG, Lanting BA. Lateral Subvastus Lateralis versus Medial Parapatellar Approach for Total Knee Arthroplasty: Patient Outcomes and Kinematics Analysis. J Knee Surg. 2024;37(7):523-529. PMID 37992725.

    PubMed · DOI

    subvastus · medial parapatellar · Comparative Study · Subscription / not open access

  23. Wang YC, Wu SH, Chen CA, Liang JM, Yang CC, Chen CH, et al.. Compare the Quadriceps Activity between Mini-Midvastus and Mini-Medial Parapatellar Approach in Total Knee Arthroplasty with Electromyography. J Clin Med. 2024;13(10):. PMID 38792280.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Open access

  24. C Katragadda B, Kumar S, Suresh A, Vk K. Midvastus Versus Medial Parapatellar Approach in Simultaneous Bilateral Total Knee Arthroplasty. J Arthroplasty. 2023;38(11):2301-2306. PMID 37271236.

    PubMed · DOI

    midvastus · medial parapatellar · Subscription / not open access

  25. Stubnya BG, Kocsis K, Váncsa S, Kovács K, Agócs G, Stubnya MP, et al.. Subvastus Approach Supporting Fast-Track Total Knee Arthroplasty Over the Medial Parapatellar Approach: A Systematic Review and Network Meta-Analysis. J Arthroplasty. 2023;38(12):2750-2758. PMID 37356465.

    PubMed · DOI

    subvastus · medial parapatellar · Systematic Review; Research Support, Non-U.S. Gov't; Network Meta-Analysis · Subscription / not open access

  26. Yang X, Cheng QH, Yang YZ, Zhang AR, Fan H, Guo HZ. Minimally invasive medial femoral approach to total knee arthroplasty improves short-term outcomes compared to the standard medial parapatellar approach: a systematic review and meta-analysis. J Orthop Surg Res. 2023;18(1):657. PMID 37667291.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Meta-Analysis; Systematic Review · Open access

  27. Dubin JA, Hameed D, Bains SS, Board T, Nunley R, Mont MA. Effect of Various Ancillary Operating Room Techniques on Wound Healing Outcomes After Total Knee Arthroplasty. Surg Technol Int. 2022;43:279-288. PMID 38109934.

    PubMed · DOI

    subvastus · medial parapatellar · Systematic Review · Subscription / not open access

  28. Geng L, Fu J, Xu C, Ren P, Wang YM, Ji QB, et al.. The Comparison between Mini-Subvastus Approach and Medial Parapatellar Approach in TKA: A Prospective Double-Blinded Randomized Controlled Trial. Orthop Surg. 2022;14(11):2878-2887. PMID 36127866.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Randomized Controlled Trial · Open access

  29. Li T, Liu Y, Li C, Zhang H. SMOC approach for total knee arthroplasty in valgus knees. J Orthop Surg Res. 2022;17(1):120. PMID 35193617.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  30. Pawar P, Shah M, Shah N, Tiwari A, Sahu D, Bagaria V. Surgeon administered direct adductor canal block is as good as ultrasound guided adductor canal block in pain management in knee replacements- A retrospective case-control study. J Orthop. 2022;31:103-109. PMID 35514532.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  31. Sogbein OA, Zomar BO, Bryant DM, Howard JL, Marsh JD, Lanting BA. Effects of Surgical Approach and Tourniquet Use on Patient-Reported Outcomes Following Total Knee Arthroplasty: A Pilot Randomized Clinical Trial. Orthop Res Rev. 2022;14:407-417. PMID 36411862.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Open access

  32. Vasiliadis AV, Chatziravdeli V, Metaxiotis D, Beletsiotis A. A Prospective Randomized Comparative Study Between Midvastus and Standard Medial Parapatellar Approaches for Total Knee Replacement Regarding the Peri-Operative Factors. Cureus. 2022;14(10):e29889. PMID 36348906.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Open access

  33. Zhao JL, Zeng LF, Pan JK, Liang GH, Huang HT, Yang WY, et al.. Comparisons of the Efficacy and Safety of Total Knee Arthroplasty by Different Surgical Approaches: A Systematic Review and Network Meta-analysis. Orthop Surg. 2022;14(3):472-485. PMID 35128816.

    PubMed · DOI · PMC

    subvastus · midvastus · medial parapatellar · Systematic Review; Network Meta-Analysis · Open access

  34. Blom AW, Hunt LP, Matharu GS, Reed M, Whitehouse MR. The effect of surgical approach in total knee replacement on outcomes. An analysis of 875,166 elective operations from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. Knee. 2021;31:144-157. PMID 34175672.

    PubMed · DOI · Open-access link

    subvastus · midvastus · medial parapatellar · Open access

  35. Bouché PA, Corsia S, Nizard R, Resche-Rigon M. Comparative Efficacy of the Different Surgical Approaches in Total Knee Arthroplasty: A Systematic-Review and Network Meta-Analysis. J Arthroplasty. 2021;36(3):1187-1194.e1. PMID 33109416.

    PubMed · DOI

    subvastus · midvastus · Systematic Review; Network Meta-Analysis · Subscription / not open access

  36. Fuller RM, Wicker DI, Getman GW, Christensen KS, Christensen CP. A Medial Subvastus Approach for Lateral Unicompartmental Knee Arthroplasty: Technique Description and Early Outcome Results. Arthroplast Today. 2021;9:129-133. PMID 34195316.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  37. Guler O, Gümüşsuyu G, Sofu H, Gökçen HB. Clinical and Radiological Outcomes of Total Knee Arthroplasty Performed with Midvastus and Medial Parapatellar Approaches in Obese Patients. Adv Orthop. 2021;2021:5512930. PMID 34721904.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Open access

  38. Khan MNH, Abbas K, Faraz A, Ilyas MW, Shafique H, Jamshed MH, et al.. Total knee replacement: A comparison of the subvastus and medial parapatellar approaches. Ann Med Surg (Lond). 2021;68:102670. PMID 34408867.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Review · Open access

  39. Lechner R, Lazzeri M, Oberaigner W, Nardelli P, Roth T, Köglberger P, et al.. Does the type of surgical approach affect the clinical outcome of total knee arthroplasty?. Orthopade. 2021;50(8):674-680. PMID 33575812.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Open access

  40. Sidhu SP, Somerville LE, Sidhu AS, Willing RT, Teeter MG, Lanting BA. Does surgical approach affect patient outcomes of total knee arthroplasty?. Can J Surg. 2021;64(5):E521-E526. PMID 34598930.

    PubMed · DOI · PMC

    subvastus · midvastus · medial parapatellar · Comparative Study · Open access

  41. Bejek Z, Holnapy G, Skaliczki G, Stubnya B, Szatmári A. [Effect of the surgical exposure on the early postoperative period after total knee arthroplasty]. Orv Hetil. 2020;161(29):1208-1214. PMID 32628620.

    PubMed · DOI

    subvastus · medial parapatellar · Observational Study · Open access

  42. Lanting BA, Legault JA, Johnson MI, MacDonald SJ, Beveridge TS. Lateral subvastus approach: A cadaveric examination of its potential for total knee arthroplasty. Knee. 2020;27(4):1271-1278. PMID 32711891.

    PubMed · DOI

    subvastus · medial parapatellar · cadaveric study · Subscription / not open access

  43. Lin W, Niu J, Dai Y, Yang G, Li M, Wang F. Mini-midvastus versus medial parapatellar approach in total knee arthroplasty: difference in patient-reported outcomes measured with the Forgotten Joint Score. J Orthop Surg Res. 2020;15(1):336. PMID 32807190.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Comparative Study · Open access

  44. Migliorini F, Aretini P, Driessen A, El Mansy Y, Quack V, Tingart M, et al.. Better outcomes after mini-subvastus approach for primary total knee arthroplasty: a Bayesian network meta-analysis. Eur J Orthop Surg Traumatol. 2020;30(6):979-992. PMID 32152747.

    PubMed · DOI · PMC

    subvastus · midvastus · medial parapatellar · Review; Network Meta-Analysis · Open access

  45. Mora JP, Scuderi GR. Minimally Invasive Total Knee Arthroplasty: Does Surgical Technique Actually Impact the Outcome?. Orthop Clin North Am. 2020;51(3):303-315. PMID 32498949.

    PubMed · DOI

    subvastus · midvastus · medial parapatellar · Review · Subscription / not open access

  46. Onggo JR, Onggo JD, Hau R. Comparable outcomes in mini-midvastus versus mini-medial parapatellar approach in total knee arthroplasty: a meta-analysis and systematic review. ANZ J Surg. 2020;90(5):840-845. PMID 32062865.

    PubMed · DOI

    midvastus · medial parapatellar · Meta-Analysis; Systematic Review · Subscription / not open access

  47. Sidhu SP, Moslemian A, Yamomo G, Vakili S, Kelly P, Willing RT, et al.. Lateral subvastus lateralis versus medial parapatellar approach for total knee arthroplasty: A cadaveric biomechanical study. Knee. 2020;27(6):1735-1745. PMID 33197812.

    PubMed · DOI

    subvastus · medial parapatellar · cadaveric study · Subscription / not open access

  48. Zora H, Güngör HR, Bayrak G, Şavkın R, Büker N. Does mini-midvastus approach have an advantageous effect on rapid recovery protocols over medial parapatellar approach in total knee arthroplasty?. Jt Dis Relat Surg. 2020;31(3):571-581. PMID 32962591.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Comparative Study; Randomized Controlled Trial · Open access

  49. Antony-Leo AP, Arun-Maiya G, Mohan-Kumar M, Vijayaraghavan PV. Structured Total Knee Replacement Rehabilitation Programme and Quality of Life following Two Different Surgical Approaches - A Randomised Controlled Trial. Malays Orthop J. 2019;13(2):20-27. PMID 31467647.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Open access

  50. Hiranaka T, Tanaka T, Fujishiro T, Anjiki K, Nagata N, Kitazawa D, et al.. A Modified Under-Vastus Approach for Knee Arthroplasty with Anatomical Repair of Soft Tissue. Clin Orthop Surg. 2019;11(4):490-494. PMID 31788174.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  51. Berstock JR, Murray JR, Whitehouse MR, Blom AW, Beswick AD. Medial subvastus versus the medial parapatellar approach for total knee replacement: A systematic review and meta-analysis of randomized controlled trials. EFORT Open Rev. 2018;3(3):78-84. PMID 29657848.

    PubMed · DOI · PMC

    subvastus · medial parapatellar · Open access

  52. Duan G, Liu C, Lin W, Shao J, Fu K, Niu Y, et al.. Different Factors Conduct Anterior Knee Pain Following Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. J Arthroplasty. 2018;33(6):1962-1971.e3. PMID 29398258.

    PubMed · DOI

    midvastus · medial parapatellar · Meta-Analysis; Systematic Review · Subscription / not open access

  53. Koçak A, Özmeriç A, Koca G, Senes M, Yumuşak N, Iltar S, et al.. Lateral parapatellar and subvastus approaches are superior to the medial parapatellar approach in terms of soft tissue perfusion. Knee Surg Sports Traumatol Arthrosc. 2018;26(6):1681-1690. PMID 28835987.

    PubMed · DOI

    subvastus · midvastus · medial parapatellar · animal study · Subscription / not open access

  54. Li Z, Cheng W, Sun L, Yao Y, Cao Q, Ye S, et al.. Mini-subvastus versus medial parapatellar approach for total knee arthroplasty: a prospective randomized controlled study. Int Orthop. 2018;42(3):543-549. PMID 29199379.

    PubMed · DOI

    subvastus · medial parapatellar · Randomized Controlled Trial · Subscription / not open access

  55. Picard F, Deakin A, Balasubramanian N, Gregori A. Minimally invasive total knee replacement: techniques and results. Eur J Orthop Surg Traumatol. 2018;28(5):781-791. PMID 29564615.

    PubMed · DOI · PMC

    subvastus · midvastus · medial parapatellar · Review · Open access

  56. Sabatini L, Nicolaci G, Atzori F, Oliva A, Aprato A, Terzolo M, et al.. Biochemical stress evaluation after medial parapatellar and subvastus approach in total knee replacement. Musculoskelet Surg. 2018;102(2):185-190. PMID 29159505.

    PubMed · DOI

    subvastus · medial parapatellar · Subscription / not open access

  57. Sartawi M, Rahman H, Kohlmann J, Leighton R, Kersh ME. A Retrospective Analysis of the Modified Intervastus Approach. Am J Orthop (Belle Mead NJ). 2018;47(12):. PMID 30650164.

    PubMed · DOI

    subvastus · medial parapatellar · Subscription / not open access

  58. Schiapparelli FF, Amsler F, Hirschmann MT. The type of approach does not influence TKA component position in revision total knee arthroplasty - A clinical study using 3D-CT. Knee. 2018;25(3):473-479. PMID 29599025.

    PubMed · DOI

    subvastus · medial parapatellar · Comparative Study · Subscription / not open access

  59. Tzatzairis T, Fiska A, Ververidis A, Tilkeridis K, Kazakos K, Drosos GI. Minimally invasive versus conventional approaches in total knee replacement/arthroplasty: A review of the literature. J Orthop. 2018;15(2):459-466. PMID 29881177.

    PubMed · DOI · PMC

    subvastus · midvastus · Review · Open access

  60. Ugbeye ME, Itakpe SE, Ayodabo OJ. Subvastus versus Medial Parapatellar Approach in Primary Total Knee Replacement: An Assessment of Early Function. West Afr J Med. 2018;35(1):15-19. PMID 29607472.

    PubMed

    subvastus · medial parapatellar · Randomized Controlled Trial · Subscription / not open access

  61. Wu Y, Zeng Y, Bao X, Xiong H, Hu Q, Li M, et al.. Comparison of mini-subvastus approach versus medial parapatellar approach in primary total knee arthroplasty. Int J Surg. 2018;57:15-21. PMID 30056128.

    PubMed · DOI

    subvastus · medial parapatellar · Comparative Study; Meta-Analysis; Review · Subscription / not open access

  62. Aslam MA, Sabir AB, Tiwari V, Abbas S, Tiwari A, Singh P. Approach to Total Knee Replacement: A Randomized Double Blind Study between Medial Parapatellar and Midvastus Approach in the Early Postoperative Period in Asian Population. J Knee Surg. 2017;30(8):793-797. PMID 28086244.

    PubMed · DOI

    midvastus · medial parapatellar · Randomized Controlled Trial · Open access

  63. Kurowicki J, Khlopas A, Sultan AA, Sodhi N, Samuel LT, Chughtai M, et al.. Improvement in hamstring and quadriceps muscle strength following cruciate-retaining single radius total knee arthroplasty. Ann Transl Med. 2017;5(Suppl 3):S27. PMID 29299474.

    PubMed · DOI · PMC

    subvastus · midvastus · Open access

  64. Shukla R, Mahajan P, Singh M, Jain RK, Kumar R. Outcome of Total Knee Replacement via Two Approaches in Indian Scenario. J Knee Surg. 2017;30(2):174-178. PMID 27213285.

    PubMed · DOI

    midvastus · medial parapatellar · Randomized Controlled Trial · Subscription / not open access

  65. Unwin O, Hassaballa M, Murray J, Harries W, Porteous A. Minimally invasive surgery (MIS) for total knee replacement; medium term results with minimum five year follow-up. Knee. 2017;24(2):454-459. PMID 28189404.

    PubMed · DOI

    subvastus · midvastus · Comparative Study; Randomized Controlled Trial · Subscription / not open access

  66. Feczko P, Engelmann L, Arts JJ, Campbell D. Computer-assisted total knee arthroplasty using mini midvastus or medial parapatellar approach technique: A prospective, randomized, international multicentre trial. BMC Musculoskelet Disord. 2016;17:19. PMID 26762175.

    PubMed · DOI · PMC

    midvastus · medial parapatellar · Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't · Open access

  67. Koh IJ, Kim MW, Kim MS, Jang SW, Park DC, In Y. The Patient's Perception Does Not Differ Following Subvastus and Medial Parapatellar Approaches in Total Knee Arthroplasty: A Simultaneous Bilateral Randomized Study. J Arthroplasty. 2016;31(1):112-7. PMID 26350260.

    PubMed · DOI

    subvastus · medial parapatellar · Randomized Controlled Trial · Subscription / not open access

  68. Langen S, Gaber S, Zdravkovic V, Giesinger K, Jost B, Behrend H. Lateral subvastus approach with tibial tubercle osteotomy for primary total knee arthroplasty: clinical outcome and complications compared to medial parapatellar approach. Eur J Orthop Surg Traumatol. 2016;26(2):215-22. PMID 26567166.

    PubMed · DOI

    subvastus · medial parapatellar · Comparative Study · Subscription / not open access

  69. Layher F, Zipfel M, Sander K, Matziolis G, Roth A. [Functional Comparison of the Outcome after Midvastus and Medial Parapatellar Surgical Approach in Total Knee Arthroplasty]. Z Orthop Unfall. 2016;154(1):50-7. PMID 26587881.

    PubMed · DOI

    midvastus · medial parapatellar · Randomized Controlled Trial · Subscription / not open access

  70. Vaishya R, Vijay V, Demesugh DM, Agarwal AK. Surgical approaches for total knee arthroplasty. J Clin Orthop Trauma. 2016;7(2):71-9. PMID 27182142.

    PubMed · DOI · PMC

    subvastus · midvastus · medial parapatellar · Review; Retracted Publication · Open access

  71. Liu H, Mei X, Zhang Z, Sun J. Mini-midvastus versus mini-medial parapatellar approach in simultaneous bilateral total knee arthroplasty with 24-month follow-up. Acta Orthop Traumatol Turc. 2015;49(6):586-92. PMID 26511683.

    PubMed · DOI · Open-access link

    midvastus · medial parapatellar · Comparative Study; Research Support, Non-U.S. Gov't · Open access

  72. Tria AJ, Scuderi GR. Minimally invasive knee arthroplasty: An overview. World J Orthop. 2015;6(10):804-11. PMID 26601062.

    PubMed · DOI · PMC

    subvastus · midvastus · medial parapatellar · Review · Open access

  73. Aydogdu S, Zileli B, Cullu E, Atamaz FC, Sur H, Zileli M. Increased turn/amplitude parameters following subvastus approach in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014;22(7):1632-7. PMID 23274269.

    PubMed · DOI

    subvastus · medial parapatellar · Comparative Study · Subscription / not open access

  74. Cho KY, Kim KI, Umrani S, Kim SH. Better quadriceps recovery after minimally invasive total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014;22(8):1759-64. PMID 23760038.

    PubMed · DOI

    midvastus · medial parapatellar · Comparative Study; Randomized Controlled Trial · Subscription / not open access

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2. Subvastus approach

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  2. Capitanu BS, Dragosloveanu S, Botnariu EG, Ionescu MV, Druica E, Nedelea DG, et al.. Cost-analysis of total knee arthroplasty with robot-assisted surgery versus conventional approach. J Robot Surg. 2026;20(1):. PMID 42217125.

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  3. Cheong T, Yeo J, King CKK, Moo IH. Kinematically aligned total knee arthroplasty via subvastus approach using the Mako® 2.0 total knee system: a surgical technique. Front Surg. 2026;13:1653726. PMID 41953492.

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  4. Kaneko T, Hayakawa K, Miyazaki T. Association of oxidized regenerated cellulose powder and tranexamic acid during total knee arthroplasty: clinical outcomes. Int Orthop. 2026;50(8):1923-1928. PMID 42132944.

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  5. Le Guen A, Marmor S, Le Strat V, Mouton A, Aubert T. Personalized alignment in total knee arthroplasty reduces patellar tilt: A retrospective study. Knee Surg Sports Traumatol Arthrosc. 2026;34(5):1766-1775. PMID 41103212.

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  10. Messieh MS, Nguyen SV. Exploring predictors of medial collateral ligament tears in lateral approach total knee replacement: A retrospective study. J Orthop. 2025;61:12-16. PMID 40051790.

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  12. Mortazavi SMJ, Soltani Farsani A, Babis G, Palacio JC, Mateu-Vicent D, Barretto JM, et al.. Do Functional Outcomes Differ Among Total Knee Arthroplasty Approaches at six, 12, and Beyond 18 Months of Follow-Up?. J Arthroplasty. 2025;40(2S1):S91-S94. PMID 39581238.

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  18. Watabe T, Sengoku T, Kubota M, Sakurai G, Yoshida S, Taniguchi Y. Knee injury and osteoarthritis outcome score and knee society score for the minimal clinically important differences after cruciate-retaining total knee arthroplasty: Two-year follow up. Knee. 2025;53:176-182. PMID 39787722.

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  19. Watabe T, Sengoku T, Muramatsu R, Kubota M, Sakurai G, Yoshida S, et al.. Preoperative factors associated with failure to achieve the minimal clinically important difference in quality of life following total knee arthroplasty. BMC Geriatr. 2025;25(1):476. PMID 40604481.

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  20. Bhattacharjee SK, Kundu Choudhury A, Priyadarshi S, Prasad A, Ahlawat A. Functional Outcome in Obese Patients Undergoing Image-Based Cruciate Retaining Robotic-Assisted Total Knee Arthroplasty Using the Subvastus Approach: A Short-Term Study. Cureus. 2024;16(9):e68430. PMID 39360092.

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  21. Jadib I, Rachidi HE, Abdennaji S, Messoudi A, Rafai M. A rare combination of sagittal fracture of the medial femoral condyle (Trélat fracture) with an ipsilateral femoral shaft fracture: A case report. Int J Surg Case Rep. 2024;119:109657. PMID 38718491.

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  22. Kawashima F, Takagi H, Kanzaki K. The relationship between the femoral artery and vastus medialis muscle coverage at the adductor hiatus during medial closed wedge distal femoral osteotomy in valgus knees. J Exp Orthop. 2024;11(3):e12082. PMID 39015343.

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  23. Lee HS, Lewis DP, Balogh ZJ. Supplementary medial plating in revision surgery for distal femoral fractures: A surgical technique with clinical outcomes. Injury. 2024;55(2):111272. PMID 38134491.

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  24. Nguyen S, Crowsey E, Dinh N, Martinez S, Rogan A, Nguyen S. Lateral subvastus approach to total knee arthroplasty: A novel surgical technique and retrospective review of 931 consecutive cases. J Orthop. 2024;49:56-61. PMID 38090604.

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  25. Patel SK, Khan S, Lohiya A, Koushik A, Patel H. Subvastus Arthrotomy and Multifaceted Fixation in Medial Femoral Comminuted Hoffa's Fracture: A Case Report. Cureus. 2024;16(4):e59121. PMID 38803775.

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  26. Jones DG, Grilliot JM. Demonstration of the Medial Subvastus Knee Exposure for MACI Implantation. Video J Sports Med. 2023;3(4):26350254231173700. PMID 40308677.

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  27. Moran TE, Tagliero AJ, Klosterman E, Ramamurti P, Sumpter AE, Diduch DR. Lateral Opening Wedge Distal Femur Osteotomy and Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Instability. Video J Sports Med. 2023;3(4):26350254231184480. PMID 40308674.

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  28. Tensho K, Kumaki D, Iwaasa T, Koyama S, Shimodaira H, Ikegami S, et al.. Anatomical implications of the subvastus approach on major vascular injury during a distal femoral osteotomy: a computed tomographic venography study. Knee Surg Sports Traumatol Arthrosc. 2023;31(4):1556-1562. PMID 35567612.

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  29. Shatrov J, Colas A, Fournier G, Batailler C, Servien E, Lustig S. Tibial tuberosity osteotomy and medial patellofemoral ligament reconstruction for patella dislocation following total knee arthroplasty: A double fixation technique. SICOT J. 2022;8:23. PMID 35699459.

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  30. Jhurani A, Agarwal P, Aswal M, Rasquinha C, Srivastava M. Subvastus Exposure Compared to Parapatellar Approach in Navigated Sequential Bilateral Total Knee Arthroplasty (SBTKA): A Prospective Randomized Study. J Knee Surg. 2021;34(6):635-643. PMID 31683350.

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  31. Jud L, Vlachopoulos L, Grob K. Correction of complex three-dimensional deformities at the proximal femur using indirect reduction with angle blade plate and patient-specific instruments: a technical note. J Orthop Surg Res. 2021;16(1):427. PMID 34217344.

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  32. Migliorini F, Aretini P, Driessen A, El Mansy Y, Quack V, Tingart M, et al.. Correction to: Better outcomes after mini‑subvastus approach for primary total knee arthroplasty: a Bayesian network meta‑analysis. Eur J Orthop Surg Traumatol. 2021;31(6):1259. PMID 34125381.

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  33. Park KH, Oh CW, Park KC, Kim JW, Oh JK, Kyung HS, et al.. Excellent outcomes after double-locked plating in very low periprosthetic distal femoral fractures. Arch Orthop Trauma Surg. 2021;141(2):207-214. PMID 33128096.

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  34. Wang ZF, Xu J, Luo FQ, Yu GY, Lin Y. [The effect of visualized saphenous nerve block through minimally invasive far medial-subvastus approach on the analgesia after total knee arthroplasty]. Zhonghua Yi Xue Za Zhi. 2021;101(21):1592-1597. PMID 34098686.

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  35. Tsukada S, Kurosaka K, Nishino M, Ogawa H, Hirasawa N. Intraoperative loose flexion gap may restrict postoperative knee flexion after J-curve design posterior-stabilized total knee arthroplasty. Eur J Orthop Surg Traumatol. 2020;30(1):147-151. PMID 31456033.

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  36. Ateschrang A, Ahrend MD, Ahmad S, Körner D, Stein T, Yesil M, et al.. [Combined posterior and anterior cruciate ligament reconstruction : Arthroscopic treatment with the GraftLink® system]. Oper Orthop Traumatol. 2019;31(1):20-35. PMID 30564843.

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  38. Sakamoto A, Okamoto T, Matsuda S. Subvastus approach for resection of subvastus osteochondroma in the distal femur. Asian J Surg. 2019;42(8):842-843. PMID 31036474.

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  39. Kawarai Y, Nakamura J, Suzuki T, Hagiwara S, Miura M, Ohtori S. Anatomical Features of the Descending Genicular Artery to Facilitate Surgical Exposure for the Subvastus Approach-A Cadaveric Study. J Arthroplasty. 2018;33(8):2647-2651. PMID 29656968.

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  40. Yao Y, Kang P, Xue C, Jing J. [A prospective randomized controlled study of total knee arthroplasty via mini-subvastus and conventional approach]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018;32(2):162-168. PMID 29806405.

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  42. Ferreira MC, Franciozi CES, Kubota MS, Priore RD, Ingham SJM, Abdalla RJ. Is the Use of Spreaders an Accurate Method for Ligament Balancing?. J Arthroplasty. 2017;32(7):2262-2267. PMID 28283428.

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  44. Tsukada S, Fujii T, Wakui M. Impact of Soft Tissue Imbalance on Knee Flexion Angle After Posterior Stabilized Total Knee Arthroplasty. J Arthroplasty. 2017;32(8):2399-2403. PMID 28390890.

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  45. Junqueira JJ, Helito CP, Bonadio MB, Pécora JR, Demange MK. Total knee arthroplasty with subvastus approach in patient with chronic post-traumatic patellar dislocation. Rev Bras Ortop. 2016;51(5):614-618. PMID 27818987.

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  50. Vansadia DV, Heltsley JR, Montgomery S, Suri M, Jones DG. Osteochondral Allograft Transplantation for Femoral Trochlear Dysplasia. Ochsner J. 2016;16(4):475-480. PMID 27999505.

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  56. Terashima T, Onodera T, Sawaguchi N, Kasahara Y, Majima T. External rotation of the femoral component decreases patellofemoral contact stress in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2015;23(11):3266-72. PMID 25026929.

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  57. Curtin B, Yakkanti M, Malkani A. Postoperative pain and contracture following total knee arthroplasty comparing parapatellar and subvastus approaches. J Arthroplasty. 2014;29(1):33-6. PMID 23639385.

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  58. Iriuchishima T, Ryu K, Aizawa S, Yorifuji H, Ohyama T, Fu FH. Anterior cruciate ligament deterioration correlates with patella osteoarthritis. Int Orthop. 2014;38(4):741-6. PMID 24132803.

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  61. Ares O, Seijas R, Hernandez A, Castellet E, Sallent A. Knee arthroplasty and bleeding: when to remove drainages. Knee Surg Sports Traumatol Arthrosc. 2013;21(2):393-7. PMID 22453310.

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  63. Lin TC, Wang HK, Chen JW, Chiu CM, Chou HL, Chang CH. Minimally invasive knee arthroplasty with the subvastus approach allows rapid rehabilitation: a prospective, biomechanical and observational study. J Phys Ther Sci. 2013;25(5):557-62. PMID 24259801.

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  64. Vaishya R, Singh AP, Vaish A. Outcome of subvastus approach in elderly nonobese patients undergoing bilateral simultaneous total knee arthroplasty: A randomized controlled study. Indian J Orthop. 2013;47(4):430-1. PMID 23960295.

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  70. In Y, Sur YJ, Won HY, Moon YS. Recurrent dissociation of the tibial insert after mini-subvastus posterior-stabilized total knee arthroplasty: a case report. Knee. 2011;18(6):461-3. PMID 20833051.

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  77. Delaunay C, Blatter G, Canciani JP, Jones DL, Laffargue P, Neumann HW, et al.. Survival analysis of an asymmetric primary total knee replacement: a European multicenter prospective study. Orthop Traumatol Surg Res. 2010;96(7):769-76. PMID 20933486.

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  78. Freiling D, van Heerwaarden R, Staubli A, Lobenhoffer P. [The medial closed-wedge osteotomy of the distal femur for the treatment of unicompartmental lateral osteoarthritis of the knee]. Oper Orthop Traumatol. 2010;22(3):317-34. PMID 20676825.

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  79. Pan WM, Li XG, Tang TS, Qian ZL, Zhang Q, Zhang CM. Mini-subvastus versus a standard approach in total knee arthroplasty: a prospective, randomized, controlled study. J Int Med Res. 2010;38(3):890-900. PMID 20819425.

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  80. Shah N, Nilesh G, Patel N. Mini-subvastus approach for total knee arthroplasty in obese patients. Indian J Orthop. 2010;44(3):292-9. PMID 20697483.

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  81. Varela-Egocheaga JR, Suárez-Suárez MA, Fernández-Villán M, González-Sastre V, Varela-Gómez JR, Rodríguez-Merchán C. Minimally invasive subvastus approach: improving the results of total knee arthroplasty: a prospective, randomized trial. Clin Orthop Relat Res. 2010;468(5):1200-8. PMID 19911245.

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  82. Viskontas DG, Nork SE, Barei DP, Dunbar R. Technique of reduction and fixation of unicondylar medial Hoffa fracture. Am J Orthop (Belle Mead NJ). 2010;39(9):424-8. PMID 21290019.

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  83. Halder A, Beier A, Neumann W. [Mini-subvastus approach for total knee replacement]. Oper Orthop Traumatol. 2009;21(1):14-24. PMID 19326064.

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  84. In Y, Kim SJ, Kim JM, Woo YK, Choi NY, Kang JW. Agreements between different methods of gap balance estimation in cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2009;17(1):60-4. PMID 18974975.

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  85. Martin A, Sheinkop MB, Langhenry MM, Oelsch C, Widemschek M, von Strempel A. Accuracy of side-cutting implantation instruments for total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2009;17(4):374-81. PMID 19132345.

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  86. Muangsiri S, Ruxasagulwong S, Kongthawornskul J, Larbpaiboonpong V, Turajane T. Clinical outcomes of minisubvastus approach for minimally invasive total knee arthroplasty. J Med Assoc Thai. 2009;92 Suppl 6:S75-9. PMID 20120668.

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  87. Omidi-Kashani F, Hasankhani IG, Mazlumi M, Ebrahimzadeh MH. Varus distal femoral osteotomy in young adults with valgus knee. J Orthop Surg Res. 2009;4:15. PMID 19435527.

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  88. Sastre S, Sanchez MD, Lozano L, Orient F, Fontg F, Nuñez M. Total knee arthroplasty: better short-term results after subvastus approach: a randomized, controlled study. Knee Surg Sports Traumatol Arthrosc. 2009;17(10):1184-8. PMID 19381612.

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  89. Turajane T, Larbpaiboonpong V, Kongtharvonskul J, Maungsiri S. Results of computer assisted mini-incision subvastus approach for total knee arthroplasty. J Med Assoc Thai. 2009;92 Suppl 6:S51-8. PMID 20120665.

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  90. Schroer WC, Diesfeld PJ, Reedy ME, LeMarr AR. Mini-subvastus approach for total knee arthroplasty. J Arthroplasty. 2008;23(1):19-25. PMID 18165023.

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  91. In Y, Kim JM, Choi NY, Kim SJ. Large thigh girth is a relative contraindication for the subvastus approach in primary total knee arthroplasty. J Arthroplasty. 2007;22(4):569-73. PMID 17562415.

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  92. Roberts VI, Mereddy PK, Donnachie NJ, Hakkalamani S. Anatomical variations in vastus medialis obliquus and its implications in minimally-invasive total knee replacement. An MRI study. J Bone Joint Surg Br. 2007;89(11):1462-5. PMID 17998182.

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  93. Schroer WC, Diesfeld PJ, Reedy ME, LeMarr AR. Evaluation of complications associated with six hundred mini-subvastus total knee arthroplasties. J Bone Joint Surg Am. 2007;89 Suppl 3:76-81. PMID 17908873.

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  94. Aglietti P, Baldini A, Sensi L. Quadriceps-sparing versus mini-subvastus approach in total knee arthroplasty. Clin Orthop Relat Res. 2006;452:106-11. PMID 16957651.

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  95. Hart R, Janecek M, Cizmár I, Stipcák V, Kucera B, Filan P. [Minimally invasive and navigated implantation for total knee arthroplasty: X-ray analysis and early clinical results]. Orthopade. 2006;35(5):552-7. PMID 16552520.

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  96. Pagnano MW, Meneghini RM. Minimally invasive total knee arthroplasty with an optimized subvastus approach. J Arthroplasty. 2006;21(4 Suppl 1):22-6. PMID 16781423.

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  97. Sink EL, Hedequist D, Morgan SJ, Hresko T. Results and technique of unstable pediatric femoral fractures treated with submuscular bridge plating. J Pediatr Orthop. 2006;26(2):177-81. PMID 16557130.

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  98. Sporer SM. The minimally invasive subvastus approach for primary total knee arthroplasty. J Knee Surg. 2006;19(1):58-62. PMID 16468497.

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  99. Zanasi S. Minimally invasive computer-assisted total knee arthroplasty through a subvastus approach. Orthopedics. 2006;29(10 Suppl):S142-4. PMID 17407942.

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  100. Cushner FD. The subvastus approach to the knee. J Knee Surg. 2003;16(1):52-4. PMID 12568268.

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  101. Chang CH, Chen KH, Yang RS, Liu TK. Muscle torques in total knee arthroplasty with subvastus and parapatellar approaches. Clin Orthop Relat Res. 2002;(398):189-95. PMID 11964650.

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  102. Hanssen AD. The subvastus approach for total knee arthroplasty resulted in better short-term outcomes than did the parapatellar approach. J Bone Joint Surg Am. 2002;84(2):325. PMID 11861749.

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  103. Scheibel MT, Schmidt W, Thomas M, von Salis-Soglio G. A detailed anatomical description of the subvastus region and its clinical relevance for the subvastus approach in total knee arthroplasty. Surg Radiol Anat. 2002;24(1):6-12. PMID 12197013.

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  104. Arnold MP, Friederich NF, Widmer H, Müller W. [Lateral approach to the knee combined with an osteotomy of the tibial tuberosity. Its use for total knee replacement]. Oper Orthop Traumatol. 1999;11(3):223-32. PMID 27520349.

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  105. Moon MS, Kim JM, Woo YK. Restoration of knee motion after total knee arthroplasty: subvastus approach and alternate flexion and extension splintage. Ryumachi. 1997;37(2):146. PMID 9136608.

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  106. Sosna A, Pokorný D. [On the "subvastus" approach in surgery of the knee joint.]. Acta Chir Orthop Traumatol Cech. 1997;64(1):15-20. PMID 20470592.

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  107. Bindelglass DF, Vince KG. Patellar tilt and subluxation following subvastus and parapatellar approach in total knee arthroplasty. Implication for surgical technique. J Arthroplasty. 1996;11(5):507-11. PMID 8872567.

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  108. Fauré BT, Benjamin JB, Lindsey B, Volz RG, Schutte D. Comparison of the subvastus and paramedian surgical approaches in bilateral knee arthroplasty. J Arthroplasty. 1993;8(5):511-6. PMID 8245996.

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  109. Hofmann AA, Plaster RL, Murdock LE. Subvastus (Southern) approach for primary total knee arthroplasty. Clin Orthop Relat Res. 1991;(269):70-7. PMID 1864059.

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    subvastus · Research Support, U.S. Gov't, Non-P.H.S.; Review · Subscription / not open access

3. Midvastus approach

  1. Poon KB, Chou JZX, Ow ZGW, Lim JW, Siow WM. The Low Mini-Midvastus Approach for Minimally Invasive Total Knee Arthroplasty. Arthroplast Today. 2025;33:101686. PMID 40309493.

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  2. Zhang H, Ma X, Chen G, Wang Z, Shang Z, Wang T, et al.. Inflammatory Marker Changes Following Total Knee Arthroplasty for Rheumatoid Arthritis with Vancomycin-Loaded Calcium Sulfate Bone Filling. J Knee Surg. 2025;38(1):13-21. PMID 39333047.

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  3. Lee PA, Wang TM, Chen YT, Wu KH, Liu HC, Lu TW. Mid-vastus total knee arthroplasty for medial osteoarthritis recovers gait balance control better than lateral parapatellar approach three months post-surgery. Front Bioeng Biotechnol. 2023;11:1133992. PMID 37034249.

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    midvastus · Open access

  4. Vaidya N, Jain A, Kulkarni N, Kale S. Long-term study of functional outcomes of robotic assisted medial UKA using mid-vastus approach in a high-volume centre. J Robot Surg. 2023;17(4):1599-1607. PMID 36928748.

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  5. Wei B, Tang C, Li X, Lin R, Han L, Zheng S, et al.. Enhanced recovery after surgery protocols in total knee arthroplasty via midvastus approach: a randomized controlled trial. BMC Musculoskelet Disord. 2021;22(1):856. PMID 34625057.

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    midvastus · Randomized Controlled Trial · Open access

  6. Zhang ZA, Feng H, Yan WN, Li HY, Zhang HN, Bai HJ, et al.. Comparison of Postoperative Effects between Medial Pivot Prosthesis and Posterior Stabilized Prosthesis. Orthop Surg. 2020;12(6):1843-1853. PMID 33094903.

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    midvastus · Comparative Study · Open access

  7. Cheng YC, Wu PK, Chen CF, Chen CM, Tsai SW, Chang MC, et al.. Analysis of learning curve of minimally invasive total knee arthroplasty: A single surgeon's experience with 4017 cases over a 9-year period. J Chin Med Assoc. 2019;82(7):576-583. PMID 31021883.

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    midvastus · Open access

  8. Yoo JH, Oh HC, Park SH, Kim JK, Kim SH. Does Obesity Affect Clinical and Radiological Outcomes in Minimally Invasive Total Knee Arthroplasty? Minimum 5-Year Follow-up of Minimally Invasive TKA in Obese Patients. Clin Orthop Surg. 2018;10(3):315-321. PMID 30174807.

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  9. Carli AV, Spiro S, Barlow BT, Haas SB. Using a non-invasive secure skin closure following total knee arthroplasty leads to fewer wound complications and no patient home care visits compared to surgical staples. Knee. 2017;24(5):1221-1226. PMID 28797879.

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  10. Wu Y, Yang T, Zeng Y, Li C, Shen B, Pei F. Clamping drainage is unnecessary after minimally invasive total knee arthroplasty in patients with tranexamic acid: A randomized, controlled trial. Medicine (Baltimore). 2017;96(7):e5804. PMID 28207503.

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    midvastus · Comparative Study; Randomized Controlled Trial · Open access

  11. Verburg H, Mathijssen NM, Niesten DD, Verhaar JA, Pilot P. Comparison of Mini-Midvastus and Conventional Total Knee Arthroplasty with Clinical and Radiographic Evaluation: A Prospective Randomized Clinical Trial with 5-Year Follow-up. J Bone Joint Surg Am. 2016;98(12):1014-22. PMID 27307362.

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  12. Liebensteiner MC, Thaler M, Giesinger JM, Fischler S, Coraça-Huber DC, Krismer M, et al.. Mini-midvastus total knee arthroplasty does not result in superior gait pattern. Knee Surg Sports Traumatol Arthrosc. 2015;23(6):1699-705. PMID 24993567.

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    midvastus · Comparative Study; Research Support, Non-U.S. Gov't · Open access

  13. Liu HC, Kuo FC, Huang CC, Wang JW. Mini-midvastus total knee arthroplasty in patients with severe varus deformity. Orthopedics. 2015;38(2):e112-7. PMID 25665115.

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  14. Zhang Y, Ye LY, Liu HX, Wen H. Quadriceps tendon pie-crusting release of stiff knees in total knee arthroplasty. J Orthop Sci. 2015;20(4):669-74. PMID 25963610.

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  15. Xu SZ, Lin XJ, Tong X, Wang XW. Minimally invasive midvastus versus standard parapatellar approach in total knee arthroplasty: a meta-analysis of randomized controlled trials. PLoS One. 2014;9(5):e95311. PMID 24845859.

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    midvastus · Comparative Study; Meta-Analysis; Review · Open access

  16. Pietsch M, Djahani O, Zweiger Ch, Plattner F, Radl R, Tschauner Ch, et al.. Custom-fit minimally invasive total knee arthroplasty: effect on blood loss and early clinical outcomes. Knee Surg Sports Traumatol Arthrosc. 2013;21(10):2234-40. PMID 23114870.

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  17. Umrani SP, Cho KY, Kim KI. Patellar eversion does not adversely affect quadriceps recovery following total knee arthroplasty. J Arthroplasty. 2013;28(4):591-4. PMID 23153598.

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    midvastus · Randomized Controlled Trial · Subscription / not open access

  18. Ast MP, DiMaio FR. Effects of a less-invasive surgical technique on cement mantle quality in total knee arthroplasty. Orthopedics. 2012;35(9):e1329-33. PMID 22955397.

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  19. Chou PH, Chen WM, Chen CF, Chiang CC, Liu CL, Chen TH. Clinical comparison of valgus and varus deformities in primary total knee arthroplasty following midvastus approach. J Arthroplasty. 2012;27(4):604-12. PMID 21890315.

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  20. Christen B, Neukamp M, Aghayev E. No difference in anterior tibial translation with and without posterior cruciate ligament in less invasive total knee replacement. Knee Surg Sports Traumatol Arthrosc. 2012;20(3):503-9. PMID 21630048.

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  21. Dabboussi N, Sakr M, Girard J, Fakih R. Minimally invasive total knee arthroplasty: a comparative study to the standard approach. N Am J Med Sci. 2012;4(2):81-5. PMID 22408753.

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  22. Maniar RN, Singhi T, Rathi SS, Baviskar JV, Nayak RM. Surgical technique: Lateral retinaculum release in knee arthroplasty using a stepwise, outside-in technique. Clin Orthop Relat Res. 2012;470(10):2854-63. PMID 22707069.

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  23. Siramanakul C, Sriphirom P. Comparison of clinical and radiographic outcomes between minimally invasive lateral approach and mini-midvastus approach in total knee arthroplasty. J Med Assoc Thai. 2012;95 Suppl 10:S53-7. PMID 23451439.

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  24. Ertürk C, Altay MA, Sipahioğlu S, Zehir S, Aşkar H. Early results of total knee arthroplasty performed through the midvastus approach. Acta Orthop Traumatol Turc. 2010;44(1):36-41. PMID 20513989.

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    midvastus · Open access

  25. Martin A, Sheinkop MB, Langhenry MM, Widemschek M, Benesch T, von Strempel A. Comparison of two minimally invasive implantation instrument-sets for total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2010;18(3):359-66. PMID 19847404.

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  26. Rechcińska-Roślak B, Gołebiowska J, Sibiński M, Synder M. Influence of surgical approach on the rehabilitation of patients after total knee arthroplasty. Ortop Traumatol Rehabil. 2010;12(2):136-43. PMID 20453252.

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  27. Hube R, Keim M, Mayr HO. [The mini-midvastus approach for total knee arthroplasty]. Oper Orthop Traumatol. 2009;21(1):3-13. PMID 19326063.

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  28. Karpman RR, Smith HL. Comparison of the early results of minimally invasive vs standard approaches to total knee arthroplasty: a prospective, randomized study. J Arthroplasty. 2009;24(5):681-8. PMID 18538536.

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    midvastus · Comparative Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't · Subscription / not open access

  29. Srivastav AK, Nadkarni B, Srivastav S, Mittal V, Agarwal S. Prophylactic use of antibiotic-loaded bone cement in primary total knee arthroplasty: Justified or not?. Indian J Orthop. 2009;43(3):259-63. PMID 19838348.

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  30. Thiengwittayaporn S, Paradeerujira S, Tanavalee A. Anatomical landmark of descending genicular artery for minimidvastus approach of the knee. J Med Assoc Thai. 2009;92 Suppl 6:S59-62. PMID 20120666.

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  31. Watanabe T, Muneta T, Ishizuki M. Is a minimally invasive approach superior to a conventional approach for total knee arthroplasty? Early outcome and 2- to 4-year follow-up. J Orthop Sci. 2009;14(5):589-95. PMID 19802671.

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  32. Wohlrab D, Zeh A, Mendel T, Hein W. [Quadsparing approach in total knee arthroplasty]. Oper Orthop Traumatol. 2009;21(1):25-34. PMID 19326065.

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  33. Zeh A, Davis J, Laskin R, Klima S, Wohlrab D. Early results with the Genesis II Posterior Stabilized High Flexion knee prosthesis. A one year follow-up study. Acta Orthop Belg. 2009;75(6):792-800. PMID 20166362.

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  34. Dai XS, Yu XZ, Wu LD, He RX, Wang XH, Yan SG. Use of mid-vastus approach in less invasive primary total knee arthroplasty. Chin Med J (Engl). 2008;121(9):787-90. PMID 18701041.

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  35. Dalury DF, Snow RG, Adams MJ. Electromyographic evaluation of the midvastus approach. J Arthroplasty. 2008;23(1):136-40. PMID 18165043.

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  36. Karachalios T, Giotikas D, Roidis N, Poultsides L, Bargiotas K, Malizos KN. Total knee replacement performed with either a mini-midvastus or a standard approach: a prospective randomised clinical and radiological trial. J Bone Joint Surg Br. 2008;90(5):584-91. PMID 18450623.

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  37. Wohlrab D, Gutteck N, Hildebrand M, Zeh A, Hein W. [Influence of the surgical approach on postoperative rehabilitation after TKA]. Z Orthop Unfall. 2008;146(2):200-5. PMID 18404583.

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  38. Chin PL, Foo LS, Yang KY, Yeo SJ, Lo NN. Randomized controlled trial comparing the radiologic outcomes of conventional and minimally invasive techniques for total knee arthroplasty. J Arthroplasty. 2007;22(6):800-6. PMID 17826268.

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  39. Laskin RS. Surgical exposure for total knee arthroplasty: for everything there is a season. J Arthroplasty. 2007;22(4 Suppl 1):12-4. PMID 17570270.

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  40. Pietsch M, Djahani O, Hofmann S. [Minimally invasive mini-midvastus approach as standard in total knee arthroplasty]. Orthopade. 2007;36(12):1120-8. PMID 17992505.

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  41. Tamurian RM, Urquhart AG. Intramuscular hematoma following a midvastus approach during primary total knee arthroplasty. Orthopedics. 2007;30(8):668-9. PMID 17727026.

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  42. Walter F, Haynes MB, Markel DC. A randomized prospective study evaluating the effect of patellar eversion on the early functional outcomes in primary total knee arthroplasty. J Arthroplasty. 2007;22(4):509-14. PMID 17562406.

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  43. Eum DS, Lee HK, Hwang SY, Park JU. Blood loss after navigation-assisted minimally invasive total knee arthroplasty. Orthopedics. 2006;29(10 Suppl):S152-4. PMID 17407945.

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  44. Goldstein WM, Gordon AC, Branson JJ. Optimizing range of motion in cruciate-retaining mobile-bearing tka: experience with 2000 cases. Orthopedics. 2006;29(9 Suppl):S71-5. PMID 17002155.

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  45. Haas SB, Manitta MA, Burdick P. Minimally invasive total knee arthroplasty: the mini midvastus approach. Clin Orthop Relat Res. 2006;452:112-6. PMID 16967036.

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  46. Laskin RS. Reduced-incision total knee replacement through a mini-midvastus technique. J Knee Surg. 2006;19(1):52-7. PMID 16468496.

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  47. Laskin RS. Mini-incision: occasionally desirable, rarely necessary in opposition. J Arthroplasty. 2006;21(4 Suppl 1):19-21. PMID 16781422.

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  48. Ohnsorge JA, Laskin RS. [Special surgical technique of minimally invasive total knee replacement]. Z Orthop Ihre Grenzgeb. 2006;144(1):91-6. PMID 16498567.

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  49. Laskin RS. Minimally invasive total knee arthroplasty: the results justify its use. Clin Orthop Relat Res. 2005;440:54-9. PMID 16239784.

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  50. Wohlrab D, Ditl J, Herrschelmann R, Schietsch U, Hein W, Hube R. [Does the NexGen LPS flex mobile knee prosthesis offer advantages compared to the NexGen LPS?--a comparison of clinical and radiological results]. Z Orthop Ihre Grenzgeb. 2005;143(5):567-72. PMID 16224678.

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  51. Haas SB, Cook S, Beksac B. Minimally invasive total knee replacement through a mini midvastus approach: a comparative study. Clin Orthop Relat Res. 2004;(428):68-73. PMID 15534521.

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  52. Reid JB, Guttmann D, Ayala M, Lubowitz JH. Minimally invasive surgery-total knee arthroplasty. Arthroscopy. 2004;20(8):884-9. PMID 15483555.

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  53. Engh GA, Ammeen DJ. The midvastus approach to the knee. J Knee Surg. 2003;16(1):48-51. PMID 12568267.

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  54. Dalury DF, Jiranek WA. A comparison of the midvastus and paramedian approaches for total knee arthroplasty. J Arthroplasty. 1999;14(1):33-7. PMID 9926950.

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  55. Keating EM, Faris PM, Meding JB, Ritter MA. Comparison of the midvastus muscle-splitting approach with the median parapatellar approach in total knee arthroplasty. J Arthroplasty. 1999;14(1):29-32. PMID 9926949.

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    midvastus · Clinical Trial; Comparative Study; Randomized Controlled Trial · Subscription / not open access

4. Medial parapatellar approach

  1. Ahmad S, Kindi NSAA, Shankar S, Kindi MNA. A Case Report of an Intra-Articular Lipoma in the Inferomedial Recess of the Anterior Knee Joint: Clinical Implications and Diagnostic Challenges: Case Report and Review of Literature. J Orthop Case Rep. 2026;16(1):248-251. PMID 41541481.

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5. Related: quadriceps-sparing, trivector, and VMO-sparing variants

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  5. Yoshida T, Ebiko J, Sasaki K, Uchiyama E, Kura H. Recovery process of the muscle activities during walking with efficient early quadriceps training and gait exercises after total knee arthroplasty. J Bodyw Mov Ther. 2022;29:49-53. PMID 35248288.

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  9. Qi YS, Yang B, Yu JK, Zhang JY, Huang AB, Wang HJ. Does Quadriceps-sparing Total Knee Arthroplasty Increase the Risk of Lower Limb and Component Malalignment? A Minimum 5-year Follow-up Study. Chin Med J (Engl). 2016;129(1):92-4. PMID 26712439.

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6. Related: parapatellar arthrotomy, side not specified in title/abstract

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  2. Huang J, Abdullah Ezzi SH, Wu S, Ali Alshabi MM, Zhang W, Malik MA, et al.. Intraosseous Sustained-Release Anesthetics Promote Early Ambulation and Functional Recovery After Total Knee Arthroplasty. J Arthroplasty. 2026;41(9):2723-2729. PMID 42264106.

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  3. Javidmehr S, Akbarzadeh A, LaPrade RF. Open Multiligament Reconstruction for Concomitant Patellofemoral and Type IV Tibiofemoral Dislocation and Bucket-Handle Medial Meniscus Injury. Arthrosc Tech. 2026:e70192. PMID 42499901.

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  4. Mueller MM, Klinger CE, Conner-Rilk S, Wang J, Shea KG, DiFelice GS, et al.. Greater medial arterial supply revealed by 7-Tesla quantitative magnetic resonance imaging, histology and high-resolution computed tomography of the patellar tendon. J Exp Orthop. 2026;13(1):e70668. PMID 41822380.

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  6. Vega TF, Thamrongskulsiri N, Pérez Lloveras GO, Cerezal Á, Casanova F, Morgan JT, et al.. Medial Meniscal Root Repair and Double Medial Femoral Condyle Aragonite-Based Scaffold Implantation. Video J Sports Med. 2026;6(2):26350254251389135. PMID 41929391.

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  8. Chen ZY, Wu HT, Xing D, Liu Q, Ke Y, Lin JH. The melorheostosis with severe knee and ankle deformity treated by total knee arthroplasty with V-Y quadricepsplasty: a case report and literature review. BMC Musculoskelet Disord. 2025;27(1):64. PMID 41437024.

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  9. Gilat R, Weissman AC, Phillips AR, Yazdi AA, Muth SA, Cole BJ. Cell-Free Aragonite-Based Scaffold With Bone Marrow Aspirate Concentrate Augmentation for Osteochondral Defects of the Knee. Video J Sports Med. 2025;5(3):26350254241303767. PMID 40600149.

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  12. Meylan A, Terrier A, Merckaert S, Wegrzyn J, Steinmetz S. Outcomes of Tibial Tubercle Osteotomy in Aseptic Revision Total Knee Arthroplasty: A Retrospective Comparative Study. JB JS Open Access. 2025;10(4):. PMID 41281372.

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  13. Ramasamy PR, Kavin S. The Significance of Fragmentation Among Bicondylar Hoffa Fractures - Case Series of Three Fractures and Review of Literature. Indian J Orthop. 2025;59(6):853-860. PMID 40511356.

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