[Minimal invasive total knee replacement in tibia first technique].

Existing techniques for minimal invasive total knee replacement use a shortened parapatellar, a quad-sparing or a midvastus approach, cut the femur first using bony landmarks as reference. Therefore an operative technique was developed to preserve the extensor apparatus entirely using a subcutaneous subvastus approach. The tibia is cut first and the following bone cuts are soft tissue tension referenced. The short term results of this and other minimal invasive techniques show accelerated rehabilitation with less postoperative pain, while the operation is prolonged with an increased risk of component malalignment. Consequently minimal invasive techniques for total knee replacement should be adopted gradually, long term results are still missing anyhow.