Four Air Squats Just Nine Days After Knee Replacement: A 78-Year-Old’s Early Recovery
Muscle-sparing subvastus knee replacement, personalized kinematic alignment, and opioid-sparing recovery with Dr. Austin Nabet.
At his nine-day postoperative appointment, this 78-year-old gentleman performed four air squats without difficulty. He also reported no postoperative opioid pain medication use through that visit.
The video captures an encouraging early milestone following knee replacement—not a completed recovery or a timetable every patient should expect to follow.
His treatment combined a muscle- and tendon-sparing subvastus approach, kinematically aligned knee replacement, and an opioid-sparing rapid-recovery protocol. These elements reflect Dr. Nabet’s emphasis on preserving healthy tissue, personalizing the reconstruction, and helping patients regain useful movement.
Muscle-sparing knee replacement: protecting the quadriceps
The subvastus approach reaches the knee beneath the vastus medialis, the muscle on the inner front of the thigh. Rather than splitting this muscle or dividing the quadriceps tendon, the surgeon mobilizes the muscle to access the joint underneath it. This preserves the continuity of the quadriceps mechanism while allowing the damaged joint surfaces to be replaced. The joint capsule still requires an incision; muscle-sparing knee replacement remains major surgery. orthojournalhms.org
For Dr. Nabet, the distinction is not simply the length of the skin incision. It is how the healthy structures beneath the skin are treated.
Kinematic alignment: personalizing how the knee is reconstructed
Kinematic alignment addresses a different part of the operation. While the subvastus approach describes how the surgeon reaches the joint, alignment guides how the replacement components are positioned.
A kinematically aligned knee replacement aims to account for the patient’s individual pre-arthritic joint lines and movement axes. Dr. Nabet’s goal is a stable, balanced reconstruction that respects the patient’s anatomy rather than treating every knee as identical. draustinnabet.com
Opioid-sparing recovery: several tools working together
This patient reported using no opioid medication during the first nine days after surgery. That does not mean he had no discomfort or used no other pain treatment.
Dr. Nabet’s opioid-sparing joint replacement program combines appropriate non-opioid medications, individualized anesthesia and pain management, swelling control, patient education, and a plan for safe movement. Opioids remain available when clinically necessary; avoiding them is not more important than treating pain appropriately. draustinnabet.com
One patient’s outcome cannot establish how much any single surgical technique, medication, or part of the recovery plan contributed.
The Perfect Knee Approach
The Perfect Knee Approach: Preserve Normal Anatomy. Restore Natural Function.
This phrase describes Dr. Nabet’s philosophy: preserve healthy structures where possible, tailor the operation to the individual, and support the return of meaningful function. It is not a separate implant or a guarantee of a perfect knee. draustinnabet.com
For this gentleman, the nine-day visit provided an opportunity to demonstrate an encouraging early return of movement. The longer-term goal remains the same: progressing safely toward the activities that matter to him.
An early milestone—not an exercise prescription
Four squats at nine days should not become a target for every knee replacement patient. This demonstration took place during a clinic appointment. Patients should perform only the exercises approved for their stage of recovery.
Dr. Nabet’s first-week message remains: control swelling, take short and frequent walks, and balance activity with recovery time. More activity is not automatically better. Follow your individualized discharge instructions and therapy plan.
Learn about your knee replacement options
Dr. Austin Nabet provides muscle-sparing knee replacement, individualized kinematic alignment, and opioid-sparing rapid-recovery care for patients in Norfolk, Virginia Beach, and throughout Hampton Roads.
Schedule a consultation to discuss your symptoms, treatment options, and whether this approach is appropriate for you.
Individual results vary. This video documents one patient at nine days after surgery and does not predict another patient’s recovery, medication needs, or long-term outcome.
The Perfect Knee Approach: Back to Pickleball Six Weeks After Bilateral Knee Replacement
At 66 years old, this gentleman has returned to the pickleball court only six weeks after his second knee replacement. He underwent staged bilateral cementless total knee replacements—his left knee six weeks ago and his right knee three months ago.
Both procedures combined several advanced joint-replacement techniques:
- A subvastus muscle- and tendon-sparing surgical approach
- Patient-specific kinematic alignment
- Cementless knee-replacement implants
- An opioid-sparing rapid-recovery protocol
The subvastus approach works beneath the quadriceps muscle, avoiding the need to cut through the quadriceps muscle or tendon. This helps preserve the normal anatomy and function of the knee’s extensor mechanism.
Kinematic alignment is designed to restore each patient’s individual alignment and joint lines instead of forcing every knee into the same standardized position. Combined with muscle- and tendon-sparing surgery, the goal is to reduce unnecessary soft-tissue disruption and help the replaced knee move and function more naturally.
For this patient, that meant returning to pickleball only six weeks after completing his staged bilateral knee replacements.
Potential benefits of this modern rapid-recovery approach may include:
- Preservation of the quadriceps muscle and tendon
- Less disruption of normal knee anatomy
- Reduced postoperative pain
- Less reliance on opioid medication
- Faster return of quadriceps function
- More natural knee motion and stability
- Earlier return to daily and recreational activities
This case reflects the philosophy behind my approach to modern knee replacement:
The Perfect Knee Approach: Preserve Normal Anatomy. Restore Natural Function.
Every patient and recovery is different. Candidacy for outpatient, muscle-sparing, kinematically aligned knee replacement depends on the patient’s anatomy, overall health, arthritis, and personal goals.
📞 Call (757) 321-3360
Request an appointment online:
https://www.atlanticortho.com/request-an-appointment/
6-Week Recovery After Muscle- and Tendon-Sparing, Kinematically Aligned Cementless Total Knee Replacement
This patient is just 6 weeks after a muscle- and tendon-sparing (subvastus), kinematically aligned, cementless total knee replacement performed by Dr. Austin Nabet for severe bone-on-bone knee osteoarthritis with a significant bow-legged (varus) knee deformity.
The procedure was performed using Dr. Nabet’s Opioid-Sparing Rapid Recovery Joint Replacement Protocol, which is designed to minimize postoperative pain, encourage early mobility, reduce reliance on opioid medications, and help patients return to their normal lives as quickly and safely as possible.
This patient’s recovery at only 6 weeks:
- Walking independently without a cane
- Pain medication required for only 2 days after surgery
- Excellent quadriceps strength and function
- Smooth, natural gait
- Significant pain relief and restoration of everyday function
Why Dr. Nabet Performs Muscle-Sparing, Kinematically Aligned Knee Replacement
Modern total knee replacement is about more than simply replacing worn cartilage—it’s about restoring how the knee functions.
Dr. Nabet utilizes a muscle- and tendon-sparing subvastus approach, helping preserve the quadriceps mechanism by avoiding disruption of the extensor mechanism whenever appropriate. This approach is combined with kinematic alignment, a personalized technique that restores each patient’s native knee anatomy rather than placing every knee into the same standardized position.
For many patients, this combination may provide:
- Less soft tissue disruption
- Less postoperative pain
- Earlier quadriceps activation
- Faster functional recovery
- A more natural-feeling knee
- Earlier return to walking and daily activities
In appropriate patients, Dr. Nabet also performs cementless total knee replacement, allowing the patient’s own bone to biologically grow into the implant for long-term fixation.
Every patient’s recovery is unique, and results depend on many factors, including overall health, bone quality, commitment to rehabilitation, and the severity of arthritis before surgery. However, this video demonstrates what is possible with modern surgical techniques, advanced implant technology, careful patient selection, and a comprehensive rapid recovery program.
If you are living with bone-on-bone knee arthritis, chronic knee pain, or a bow-legged (varus) knee deformity, and want to learn whether you are a candidate for muscle-sparing, kinematically aligned, cementless total knee replacement, schedule a consultation with Dr. Austin Nabet, fellowship-trained orthopedic surgeon specializing in hip and knee replacement in Norfolk, Virginia Beach, and throughout Hampton Roads.
Muscle & tendon sparing subvastus, personalized kinematically aligned total knee replacement, a modern approach for a more natural feeling knee
Severe knock-knee valgus deformity and bone-on-bone osteoarthritis can make every step painful.
This 46-year-old patient with debilitating left knee pain from severe knock-knee valgus deformity 9 days post operative from a subvastus muscle- and tendon-sparing, kinematically aligned rapid recovery knee replacement to correct deformity, relieve pain, and restore motion.
At just 9 days after surgery, the result?
- Pain medication for only 2days
- Walking normal with no cane
- Normal quad muscle function & strength
This is why modern muscle-sparing knee replacement and kinematically aligned total knee replacement are changing what recovery can look like for the right patient.
Rather than forcing every knee into the same position, kinematic alignment is designed to match the patient’s native anatomy and help create a more natural-feeling knee after surgery.
Benefits may include:
- Reduced soft tissue disruption
- Less pain after surgery
- Faster functional recovery
- More natural knee movement
Dr. Austin Nabet offers advanced solutions for patients with knee osteoarthritis, valgus knee arthritis, deformity correction, and rapid recovery total knee replacement.
If you are living with chronic knee pain and wondering whether surgery can feel more natural and recover faster, this may be the option you’ve been looking for.
Muscle & tendon sparing subvastus, individualized kinematically aligned total knee replacement, a modern approach for a more natural feeling knee
From bone-on-bone misery to moving like herself again in just weeks, this 62-year-old woman had lived with crippling right knee pain for years—severe knock-knee valgus deformity had ground her joint down to bone-on-bone osteoarthritis. Every step hurt. Until she chose a different path.
Dr. Austin Nabet performed a muscle- and tendon-sparing subvastus kinematically aligned rapid-recovery knee replacement that respected her body’s natural anatomy instead of forcing it into a "standard" position.
The result?
- Only 3 days of pain medication
- Discharged from physical therapy at 3 weeks
- Full return to her pre-arthritis range of motion
No big incisions through muscle. No forced "straight" knee that never felt right. Just a knee that feels like hers again.
Tired of knee pain stealing your life? There’s a smarter, more natural way forward. Dr. Austin Nabet’s approach combines subvastus muscle-sparing technique with true kinematic alignment—the modern gold standard that restores your knee’s original alignment, motion, and feel.
Why patients are choosing this:
- Zero muscles or tendons cut
- Dramatically less post-op pain
- Lightning-fast recovery and return to daily life
- Natural knee kinematics so it bends, twists, and moves the way it was meant to
If you’re done with "just live with it" or one-size-fits-all knee replacements, this is the difference that actually changes everything.
muscle & tendon sparing subvastus, kinematically aligned knee replacement, a modern approach for a more natural feeling knee
This 69-year-old male with debilitating left knee pain from bone on bone osteoarthritis underwent a muscle and tendon sparing subvastus kinematically aligned knee replacement, discharge from therapy at 4 weeks after surgery, achieving his pre-arthritis knee range of motion!
Struggling with Knee Pain?
There’s a better, more natural option.
Dr. Austin Nabet specializes in muscle- and tendon-sparing subvastus, kinematically aligned knee replacement, a modern approach that preserves your anatomy and restores your knee’s natural motion.
By combining muscle and tendon sparing techniques with kinematic alignment, this advanced procedure is designed to deliver a more natural-feeling knee, less pain, and a faster recovery.
- No muscles or tendons cut
- Less post-operative pain
- Rapid recovery & quicker return to daily activities
- Kinematic alignment for more natural knee motion and function
Muscle-Sparing Anterior Hip Replacement | Less Pain & Faster Recovery
This 57-year-old female with debilitating right hip pain from bone on bone hip osteoarthritis underwent a muscle and tendon sparing direct anterior right hip replacement, returning to work in just under nine days after surgery!
Struggling with Hip Pain?
There’s a better option.
Dr. Austin Nabet performs a muscle- and tendon-sparing direct anterior hip replacement designed to reduce pain and help patients recover faster.
- No muscles or tendons cut
- Less post-operative pain
- Faster recovery & quicker return to daily activities
- More natural hip function with modern implant positioning
Left muscle & tendon sparing subvastus knee replacement utilizing a kinematic alignment technique
44 year old male with bilateral post-traumatic knee arthritis after multiple failed knee surgeries now post-operative from left muscle and tendon sparing subvastus knee replacement utilizing a kinematic alignment technique by Dr. Nabet.
