This can be confusing as there are two definitions here - one is the standard method of accessing the knee joint, the other is old-fashioned. Even then there are a variety of different incisions but they vary only slightly. All start with the incision in skin which can vary greatly - but the only factor governing this is surgeon's preference! They can be straight down the middle curved "S" shaped And even with bilateral knees done at the same time, the incisions can vary in length and style! Once inside, through the fat and superficial tissues, the surgeon gets to the major muscular structures on top of the joint Here there are well described pathways to make this part of the incisions the median parapatellar (first image) being the most popular. The mid or subvastus incisions are commonly used for partial knees where the opening into the knee needs to be more to the side. So you can see here there are a number of ways of taking the top end of the incision to avoid the dreaded 'quads snip'. The "Quads Snip" Years ago, surgeons actually used to extend this intrusion into the muscle of the quads (see the red line in the image in the next post) as it was believed it provided better access to the joint but time and experience showed this to be untrue and more than that, to retard the patient's recovery so over the years it was gradually dropped from use. However, the tale still lives on!