Mini incision: occasionally desirable, rarely necessary: in the affirmative.

Exposure is a crucial issue in total knee arthroplasty, and the basic surgical principles of exposure apply to the knee just as to other operations. The skin and muscle must not be stretched, and the surgeon must have an excellent view and access to the knee structures. Stretching of the skin or muscles causes damage, hurts the patient, and predisposes to infection. There is no discernable advantage to compromises on exposure to avoid incising the muscle or skin. Many of the advantages credited to smaller skin incisions likely are because of improvements in pain management. Infiltrating with local anesthetics and using shorter tourniquet times may help the patient recover more quickly. Inadequate exposure does not.