Minimally Invasive, Muscle-Sparing Knee Replacement in Dallas and Frisco

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A knee replacement should give you your life back, not put it on hold. Dr. Brad Waddell performs total knee replacement through the subvastus approach, a minimally invasive technique that spares the quadriceps muscle and tendon. His goal is to return you to a healthy, active lifestyle as quickly and safely as possible.

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What is a total knee replacement?

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In a total knee replacement, the surgeon replaces the arthritic cartilage in the knee with metal on the end of the femur (thigh bone) and the top of the tibia (shin bone). A piece of plastic sits between the two metal surfaces and acts as the new smooth cartilage. The under-surface of the patella (kneecap) can be replaced with plastic as well.

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Why the quadriceps matters

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The quadriceps is the large muscle group on the front of your thigh. It connects to your kneecap through the quadriceps tendon, and together they straighten your knee. You use them to stand from a chair, climb stairs, walk downhill, and push off in almost every sport. After knee replacement, quadriceps strength is one of the biggest factors in how quickly you get moving again.

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What is the subvastus approach?

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"Subvastus" means "under the vastus," the part of the quadriceps on the inner side of your thigh. In a traditional knee replacement, the surgeon cuts through the quadriceps tendon to reach the joint. In the subvastus approach, Dr. Waddell lifts the lower edge of the muscle and works beneath it. The muscle and its tendon are moved aside, not cut.

 

This is why Dr. Waddell's incision sits toward the inner side of your knee and not down the middle. The same implants are placed in the same position. The difference is what is left untouched on the way in.

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Why muscle- and tendon-sparing surgery matters

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• Your quadriceps stays intact. The muscle and tendon that straighten your knee are not cut and do not have to heal.

• Earlier control of your leg. Studies of the subvastus approach have shown earlier return of quadriceps strength and the ability to lift the leg sooner after surgery.

• Less early pain. Leaving the tendon intact is intended to reduce pain in the first weeks of recovery.

• A smaller incision. Minimally invasive technique means less disruption to the tissue around the knee.

• Built for rapid recovery. Muscle-sparing surgery is the foundation of Dr. Waddell's rapid recovery [and outpatient] joint replacement program.

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Precision with robotic assistance

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Muscle-sparing surgery is paired with technology. Dr. Waddell uses robotic and Artificial Intelligence (AI) technology to plan and place the implants for your anatomy. Accurate positioning has been shown to improve function and the life expectancy of the implant. Learn more about robotic-assisted joint replacement.

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Is a partial knee replacement an option?

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If arthritis is limited to one part of your knee, you may not need a total knee replacement. A partial (unicompartmental) knee replacement replaces only the damaged compartment and preserves the rest of the knee. Dr. Waddell will tell you which option fits your knee.

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When should I have a knee replacement?

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After an evaluation, Dr. Waddell will tell you whether you meet the criteria for knee replacement based on your symptoms, history, physical examination, and imaging studies. He will discuss all of your treatment options with you.

In general, it is time to consider knee replacement when you have more bad days than good days, when your pain keeps you from your daily activities, and when non-operative treatments have failed. If you are not sure your knee is the source, start with our knee pain guide.

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Am I too young for a knee replacement?

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In the past, a knee replacement at a young age usually meant another surgery later in life. That is still possible, but today's implants last much longer than previously thought. Based on studies performed over many years, most knee replacements are expected to last 15 to 25 years. Better materials and more accurate placement will likely extend that.

For active patients, the cost of waiting is real: lost strength, lost fitness, and years away from the activities you enjoy.

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Why choose Dr. Waddell

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• Performs muscle- and tendon-sparing (subvastus) knee replacement as his standard approach.

• Fellowship-trained in adult reconstruction and joint replacement at the Hospital for Special Surgery in New York.

• Board-certified orthopaedic surgeon at Carrell Clinic, serving Dallas and Frisco.

• Experienced with athletes and former professional athletes who wanted to stay active after joint replacement.

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Frequently asked questions

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-Is subvastus the same as "quad-sparing" knee replacement?
The terms are often used together. Subvastus is the specific technique: the surgeon works under the quadriceps and leaves both the muscle and the tendon intact.

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-Why is my incision on the side of my knee?
The subvastus approach reaches the joint from beneath the inner quadriceps, so the incision sits toward the inner side of the knee and not down the middle.

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-Is the subvastus approach right for everyone?
Most patients are candidates. Dr. Waddell will review your X-rays, anatomy, and goals and tell you which approach is right for your knee.

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-What does "subvastus" mean? It means "under the vastus," the part of the quadriceps muscle on the inner thigh. The surgeon works beneath the muscle and leaves the muscle and tendon intact.

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-Is the subvastus approach right for everyone? Yes. Most patients are candidates. Dr. Waddell will review your X-rays, anatomy, and goals and tell you which approach is right for your knee.

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-Is the implant different? No. The implants are the same as in a traditional knee replacement. Only the path to the joint is different.

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-How long will my knee replacement last? Most knee replacements are expected to last 15 to 25 years.

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-When can I return to sports? Dr. Waddell typically allows his patients to return to full activity 3-6 months after surgery.

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-Can I get a second opinion?Yes. Dr. Waddell sees patients for second opinions in Dallas and Frisco.

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Schedule a consultation

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If knee pain is keeping you from the life you want, call (214) 220-2468, ext. 3329, or request an appointment.

• Dallas: 9301 North Central Expressway, Dallas, TX 75225

• Frisco: 3800 Gaylord Parkway, Suite 700, Frisco, TX 75034