For individuals living with arthritis, joint replacement often becomes the only lasting solution for pain relief and restored mobility. However, the thought of a major surgical procedure and the recovery that follows can feel overwhelming.

In recent years, orthopaedic surgeons like Dr. Cory Calendine have embraced advanced, patient-focused approaches to knee replacement that blend innovative surgical techniques with cutting-edge technology—offering safer procedures and smoother recoveries tailored to each individual.

“My job is to match the surgical approach to the patient—never the other way around,” said Dr. Calendine.

The Approach: Subvastus Knee Replacement with Robotics

One of the latest techniques gaining traction is subvastus (or “subV”) knee replacement—a minimally invasive procedure enhanced by robotic assistance. This method offers a muscle-sparing alternative to traditional knee replacement.

In standard procedures, surgeons often split the quadriceps tendon, which can increase trauma, pain, and recovery time. By contrast, the subvastus technique allows the surgeon to work beneath the quadriceps muscle without cutting it, preserving muscle integrity. This is why the approach is commonly referred to as “quadriceps-sparing” or “muscle-sparing.”

“SubV protects the quad—the engine of the knee—so patients often feel stronger and recover faster,” Dr. Calendine explained.

To enhance this approach, Dr. Calendine incorporates robotic technology. It begins with a CT scan of the patient’s leg, which is used to create a custom 3D model. This allows the surgical team to pre-plan the procedure with personalized implant sizing and alignment. During surgery, advanced software provides a GPS-like roadmap that ensures precise bone removal and protects surrounding tissues.

“Robotics gives me a GPS in the operating room,” said Dr. Calendine. “It allows for a personalized knee replacement while minimizing trauma to nearby structures.”

Key Advantages of the SubV + Robotics Combination

This advanced combination offers several significant benefits:

• Early Functionality: Muscle preservation often allows for easier movement—such as standing, walking, and climbing stairs—within the first few weeks.
• Surgical Precision: Robotic planning helps ensure accurate implant positioning and ligament balance, resulting in a more natural-feeling knee.
• Consistent Outcomes: With a preoperative blueprint and real-time surgical guidance, variability is reduced and outcomes are more predictable.

In practical terms, many patients experience less early postoperative pain and a smoother initial rehabilitation period, while long-term results are supported by accurate joint alignment and soft tissue preservation.

Who is a Candidate?

According to Dr. Calendine, most patients undergoing total knee replacement for osteoarthritis may be candidates for the subvastus technique with robotic assistance. However, several factors—including limb alignment, previous incisions, body shape, stiffness, and surgical history—must be evaluated first.

“Candidacy is not a template. It’s a conversation,” said Dr. Calendine. “We consider each patient’s overall health and goals before developing a surgical plan.”

Patients with severe stiffness, complex deformities, or multiple prior surgeries may require an alternative approach. That’s why a thorough consultation with an experienced provider is essential.

What to Expect After Surgery

While the SubV approach may reduce pain and speed recovery, swelling control, early motion, and consistent physical therapy remain critical components of healing. Dr. Calendine and his team work closely with every patient to set expectations, provide education, and guide them through every step of the recovery process.

“Great outcomes are not an accident,” said Dr. Calendine. “They come from preparation, precision, and a true partnership between patient and provider.”

Questions to Ask Your Surgeon

If you are considering knee replacement surgery, Dr. Calendine recommends asking the following:

• Do you offer a quadriceps-sparing approach like SubV?
• Do you use robotic planning and assistance?
• How will you personalize the alignment and balance for my knee?

“My job is not to just replace a joint,” said Dr. Calendine. “It is to help someone return to the life they love—with a plan built around their body and goals.”

To learn more about joint replacement options at Bone and Joint Institute of Tennessee, visit www.boneandjointtn.org.