The surgical techniques associated with the variety of minimally invasive surgery (MIS) approaches for total knee arthroplasty (TKA), including the limited parapatellar, limited midvastus, limited subvastus, and quadriceps-sparing approaches, are reviewed. The patient selection criteria for mini-incision TKA are detailed. Although clinical experience with these approaches is limited, initial results seem promising and potentially adaptable to a majority of cases with modifications in either instruments or components customized for the procedure. MIS TKA represents a continuum in complexity, and surgeons should gain experience sequentially. The extensibility of these approaches allows surgeons to adapt and modify the procedure should intra-operative difficulties arise.
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