MIN Surgery®

Minimal Incision Total Knee Arthroplasty

New Technique in Surgical positioning

Peter M. Bonutti, MD

Bonutti Orthopedic Clinic, Effingham, IL


Surgical techniques used in performing Total Knee Arthroplasty (TKA) have been essentially unchanged for over 20 years.  The patient is positioned supine and a 20-30 cm (8-12 inch) incision is made with the leg extended.  The patella is then everted and the knee is flexed with retractors used to expose the arthrotomy site.  While this extensive exposure aids in aligning the knee enhancing visualization of landmarks and allowing the use of bulky instruments to complete the bone preparation for implants,  it imposes significant trauma to the quadriceps mechanism and soft tissue.


Suspended Leg

Click on Image for larger view

Click on Image for larger view

Patella Everted

Patella Retracted

A Minimally Invasive Total Knee Replacement (MIN TKA) procedure has been developed utilizing the new Suspended Leg Technique.  The patient's leg is placed in a leg holder and flexed over the edge of a surgical table allowing the weight of the leg to distract the joint and push tissue away.  Sterile draping is possible and a mobile, sterile field is created that allows sequential flexion and extension as needed.  The surgeon can be in a sitting or standing position during the procedure.


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