Over the past 30 years, there has been much interest in performing all types of surgery via less-invasive techniques. The term "minimally-invasive" surgery or "MIS" surgery has been used and probably overused as a selling point for a procedure can be performed with less trauma to the patient. Such terms are often used as an argument for why a patient should choose one surgeon over another.
In the setting of total knee replacement, research has been done to understand whether the procedure can be done safely with "MIS" techniques. And if so, does it improve either the short- or long-term outcomes after surgery? The phrase "Quad-sparing TKA" has also found its way into the conversation about knee replacement surgical techniques.
Most recently, there has been a direct-to-consumer marketing effort for the "Jiffy Knee". The "Jiffy Knee" is not an actual knee replacement prosthesis. It is a catchy phrase that is being used to describe a "Sub-vastus" or "Southern" surgical technique that was first described for knee surgery in 1991 by Dr Aaron Hoffman. Unfortunately, 21st-century internet and social media marketing is being used to convince patients that this is a "new" surgical technique that will spare them from postoperative pain after knee replacement and shorten their recovery.
To date, the research has been inconclusive as to whether a quad sparing "MIS" TKA technique, which includes the "Jiffy Knee", is in fact better. Several studies have shown quicker recovery of range of motion, earlier ambulation and active straight leg raise ability. Yet, other studies have shown an increased risk in early post-operative complications such as wound healing complications, arthrofibrosis (knee stiffness), ligament injury or even catastrophic patellar tendon rupture.
One study evaluating a "quad-sparing" TKA technique demonstrated that 30% of patients suffered traumatic tears of the quadricep tendon during surgery that required surgical repair.
When a patient is considering a potential knee replacement surgery, keep in mind that it is the long-term outcome that is most important. Having knee replacement via a smaller incision that might put you at risk for more complications and potentially additional surgery. To focus on the short term rather than the long term is, in other words, probably misguided.
Dr Kaper routinely utilizes the less-invasive knee replacement surgical techniques, including the "Jiffy" sub-vastus approach, that is appropriate for the individual patient and their specific anatomy and pathology. Not every patient is the same and it is only logical that there is not one simple approach that that can be used for all patients.
If you have specific questions or concerns about the techniques used to TKA surgery, please let us know.