الفهرس 
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Abstract
Total knee arthroplasty is the end-stage treatment of arthritis in patients who failed conservative treatment providing significant pain relief and improved joint function. Primary technical objectives for the success of this intervention consist mainly in realignment of the lower extremity mechanical axis, adequate implant orientation, good and stable implant fixation, proper soft tissue balancing and proper patellofemoral realignment.
Secondary technical objectives of total knee replacement include early walking with no pain, rapid rehabilitation and faster return to normal daily activities. A good exposure should achieve these goals without compromising the primary objectives.
Although several surgical approaches to the knee exist, the medial parapatellar approach is the most common approach performed by orthopaedic surgeons. This approach allows adequate patellar eversion and sufficient knee flexion to expose the knee joint, but unfortunately the incision through the quadriceps tendon may impair the extensor mechanism of the knee post-operative.
The subvastus approach was popularized by Hoffman in 1991. The subvastus technique completely spares both the quadriceps tendon and muscle and provides exposure of the knee joint for the replacement operation.