Specialized instruments and modular implants for minimally invasive total knee arthroplasty.

To optimize the benefits potentially achievable with minimally invasive surgery (MIS) total knee arthroplasty (TKA), the surgeon must operate through a smaller incision without compromising the surgical result. Initial efforts in this regard centered on using miniaturized instruments and ancillary navigational instruments to compensate for reduced visualization. With the advent of the quadriceps-sparing approach came the side-cutting tool, which had additional applications in other MIS TKA approaches. Innovation has occurred not only in MIS TKA instrumentation but also in components, such as MIS precoated stemmed tibial implants. MIS implants are now available in modular components that can be assembled in vivo with specialized insertion and locking tools. Although clinical experience is still limited, initial experience with new instrumentation and components for MIS seems promising, and technological development continues.