Subvastus Knee Replacement

What is Subvastus Knee Replacement?

Knee replacement is a surgical procedure where the surgeon replaces a worn-out or damaged part of the knee with artificial components called implants or prostheses made of metal, plastic, or ceramic. Subvastus knee replacement in Delhi is a type of knee replacement surgery used to access the knee joint to perform a total knee replacement surgery.

This approach aims to minimise trauma to the quadriceps muscle, leading to quicker recovery and improved postoperative outcomes. The subvastus knee replacement approach is also called the quadriceps-sparing approach or muscle-sparing knee surgery. This procedure involves accessing the knee joint by lifting the vastus medialis muscle without actually cutting it.

Benefits of Subvastus Knee Replacement

• According to reports, patients who undergo subvastus knee replacement surgery show significant improvement in functional outcomes. These studies suggest that this procedure offers long-term relief, resulting in better knee stability, mobility, and overall joint performance.
• This procedure results in an improved range of motion. You will notice notable gains in knee flexion, which helps you bend your knee better than before, especially during your postoperative period.
• The surgery avoids cutting the quadriceps tendons, which helps maintain and preserve the natural muscle mechanism and reduces long-term weakness or extensor lag.
• As the surgery doesn’t involve making an incision in the quadriceps, there is less scar formation and fibrosis, which helps maintain better knee flexibility in the long run.
• Statistics suggest that long-term follow-up after this surgery doesn’t require revision surgery in most patients.
• After the surgery, the patients are able to maintain improved mobility and activity levels for years due to preserved muscle function and enhanced knee mechanics.

Subvastus Knee Replacement vs. Traditional Methods

• Incision Size: The size of the incision in the subvastus knee replacement is smaller, measuring 3-5 inches. On the other hand, the size of the incision made in a traditional total knee replacement is 8-12 inches, as the latter involves cutting the quadriceps.
• Primary Mechanism: Subvastus knee replacement involves a surgical replacement of the damaged knee joint with an artificial implant using a muscle-sparing technique. Under traditional knee replacement, the damaged knee joint surfaces are replaced with an artificial implant.
• Invasiveness: As the incisions made in the subvastus knee replacement are small, it is a minimally invasive procedure. Traditional surgery, on the other hand, is an open surgery approach.
• Recovery Time: The recovery time after subvastus knee replacement is shorter, ranging from 4-6 weeks for most activities and up to 6 months until full recovery. The recovery time after traditional knee replacement surgery is longer, ranging up to 1 year until full recovery.
• Complications: Although a minimally invasive procedure, subvastus knee replacement may result in complications such as implant failure, pain and swelling, stiffness, allergic reactions, and fracture. The risk of complications after traditional surgery is potentially higher, including higher muscle weakness, severe pain, and more blood loss.
• Suitability: Subvastus knee replacement is a suitable option in cases of severe arthritis, especially osteoarthritis of one compartment, or for patients who are in good health and seek faster recovery. On the other hand, total knee replacement is a more suitable option for patients with complex deformities, patients who are not suitable for MIS TKR, or those opting for revision surgery.

How is Subvastus Knee Replacement Surgery Performed?

• Before the procedure, you will be given general or regional anaesthesia so you don’t feel any pain or discomfort throughout the procedure.
• The surgeon makes an incision over the front of the knee following a medial alignment so that the major nerves or blood vessels are not traumatised.
• The vastus medialis muscle is gently lifted without cutting, and the muscle fibres are separated to access the underlying joint. The surgeon also moves the patella or kneecap aside to gain access to the knee joint. This approach spares the quadriceps tendon and minimises muscle trauma.
• After the previous step, they remove the damaged surfaces of the femur and tibia and shape them to fit prosthetic components.
• Once the bone preparation is completed, they place and secure the artificial knee components.
• The surgeon checks the alignment and movement of the new joint to ensure proper function.
• The muscle is then returned to its normal position, and the incision is closed with staples or sutures.

Recovery

Most patients after the surgery can walk with assistance the same day as the procedure. As your quadriceps muscles remain intact, you will experience better initial stability and control compared to traditional surgery.

• In the first week, you will experience normal post-surgical discomfort. The surgeon will put you on a rehabilitation program and prescribe pain management medication.
• In the second or third week after the surgery, you will be able to transition from a walker to a cane. Your sleep quality will improve, and you will experience reduced pain.
• By the first or second month after the surgery, you will achieve significant functional independence. You can resume activities like returning to work, driving, and participating in all the low-impact activities.
• The long-term recovery after the surgery takes around 6-12 months. It is vital to follow up with the surgeon from time to time during this period to avoid complications.

Cost of Subvastus Knee Replacement Surgery in Delhi

The cost of subvastus knee replacement surgery in Delhi ranges from 1,00,000 INR to 2,50,000 INR, respectively. Several factors influence this cost, including:

• The choice of the hospital plays a key role in deciding the cost. Different hospitals have varying pricing structures, depending on their facilities and reputation.
• Private room charges are higher than those in a semi-private or general ward, affecting the overall cost of the surgery.
• A highly skilled surgeon charges a higher fee to perform the surgery.
• The final cost of the procedure further depends on any unforeseen complications during or after the surgery.

Why Choose Dr. Ashwani Maichand for Subvastus Knee Replacement Surgery?

Dr. Ashwani Maichand is a reputed joint replacement surgeon in Delhi with over three decades of experience in orthopaedics and minimally invasive total knee replacement (TKR). His specialisation in advanced techniques, including subvastus knee replacement, helps patients recover faster with less pain and minimal tissue damage.

Throughout this career, Dr. Maichand has performed over a thousand joint replacement surgeries with a high success rate, giving him deep expertise in solving complex knee conditions. With his years of experience combined with advanced techniques and patient-focused care, Dr. Maichand is a trusted choice for safe and effective subvastus knee replacement surgery.

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Looking for expert care? Consult Dr. Ashwani Maichand today for a personalised assessment and tailored treatment plan.