A surgical technique that avoids cutting the quadriceps muscle during knee replacement is being used by several surgeons at The Ohio State University Wexner Medical Center. This approach, known as quadriceps-sparing surgery, can reduce recovery time by about a month for eligible patients.
The quadriceps are four muscles located on the front of the thigh. They play a key role in extending the knee and stabilizing the leg during movement. Traditional knee replacement surgery often involves making an incision through part of these muscles to access the joint, which can lead to longer recovery times and extended physical therapy—typically lasting 12 to 16 weeks.
With the quad-sparing method, surgeons work around the quadriceps and use smaller incisions. This minimizes trauma to surrounding tissue and preserves nerve connections, which may result in less postoperative pain, faster return of knee strength, and a shorter rehabilitation period. "It’s technically more challenging and often requires greater expertise from the surgeon. Many surgeons, especially those treating very muscular patients, may avoid it because of its difficulty even when it’s possible to perform." By sparing the muscle, patients may experience a more natural-feeling knee after surgery.
Not all patients are candidates for this procedure. Ideal candidates have relatively good muscle strength, minimal bone deformity, and less complex knee disease. Those with severe joint damage or unusual bone structure may not be suitable for this technique. "It's crucial that the care team selects appropriate candidates to ensure the best possible outcomes and avoid disappointment from unrealistic expectations."
Ohio State is tracking patient outcomes with this technique compared to traditional methods as part of its ongoing efforts to improve health care options for joint replacement. Quad-sparing surgery is gaining attention as more people seek alternatives that offer quicker recoveries.
The age profile of knee replacement recipients has shifted in recent years; now about 75% are younger than 70 years old, with approximately 25% under age 50. Many younger patients have sports-related injuries or past issues such as torn ACLs that contribute to post-traumatic arthritis.
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