BackInAction™ Knee in South Bend
Muscle-sparing approach with Mako SmartRobotics™
Dr. Adam Cien performs BackInAction™ Knee, a muscle-sparing approach with Mako SmartRobotics™, for patients in South Bend and across Michiana, Northern Indiana and Southwest Michigan.
BackInAction Knee brings together two things Dr. Cien already relies on for knee replacement: a muscle-sparing approach that works under the quadriceps instead of through it, and Mako SmartRobotics™ for a personalized surgical plan built from a CT scan of your knee.
Don’t just recover. Get BackInAction. 3,4
How BackInAction™ Knee works
In a traditional knee replacement, the surgeon makes an incision through one of the largest muscle groups in the body, the quadriceps.
With a muscle-sparing approach, the surgeon lifts and moves the quadriceps rather than cutting it, reaching the knee joint from under the muscle instead of through it. This helps minimize the impact on the quadriceps muscles and tendon.
A muscle-sparing approach may result in less pain and faster recovery than a traditional approach. 1,2
The muscle-sparing incision does not go through the quadriceps muscles or tendon.
BackInAction™ Knee animation (54 seconds, no sound)
The role of Mako SmartRobotics™
Before surgery, a CT scan of your knee is used to create a 3D model of your joint. Dr. Cien uses that model to build a personalized surgical plan, helping determine implant size and placement for your anatomy. During surgery, the Mako System helps him carry out that plan.
Dr. Cien has performed more than 3,000 hip and knee replacements, about 2,000 of them with Mako, and is accredited as a Master Surgeon in Robotic Joint Replacement by Surgical Review Corporation.
More about Mako Robotic-Arm Assisted Technology for total knee replacement
Is it right for you?
Not every knee is a candidate for a muscle-sparing approach. Muscle size, body size, prior knee surgery and how stiff the knee is all play a part. Dr. Cien will examine your knee and review your imaging, then recommend the approach that gives your knee the best result.
Individual results vary. Not all patients will have the same postoperative recovery and activity level.
One approach, several names
You may also see this approach called subvastus, quad-sparing or muscle-sparing knee replacement. Each describes the same idea: reaching the knee from under the quadriceps instead of cutting through it.
Read more about quad-sparing (subvastus) knee replacement
Heard about the Jiffy Knee? Here is what it is
Talk it through
The best way to find out whether BackInAction™ Knee is right for you is a consultation with Dr. Cien. His offices are in South Bend, Mishawaka, Plymouth and Elkhart, and he sees patients from across Michiana, Northern Indiana and Southwest Michigan, including Granger, Goshen, La Porte, Michigan City, Niles, St. Joseph and Benton Harbor.
Call or book a consultation online.
Questions patients ask about BackInAction™ Knee. Place directly below the closing box. Ten questions, in this order.
What is BackInAction™ Knee?
Is BackInAction Knee available in South Bend and Michiana?
Yes. Dr. Adam Cien performs BackInAction Knee. He has offices in South Bend, Mishawaka, Plymouth and Elkhart and sees patients from across Northern Indiana and Southwest Michigan.
How is it different from a traditional knee replacement?
A traditional knee replacement uses an incision through the quadriceps muscle and tendon. BackInAction Knee works under the quadriceps instead, which helps minimize the impact on the muscle and tendon.
Is BackInAction Knee the same as a subvastus or quad-sparing knee replacement?
BackInAction Knee uses a muscle-sparing approach that works under the quadriceps, which surgeons call the subvastus or quad-sparing approach, and pairs it with Mako SmartRobotics™. Dr. Cien’s quad-sparing knee replacement page explains the approach in more detail.
Is BackInAction Knee the same as the Jiffy Knee?
No. They are separate brand names with different owners, and both describe muscle-sparing knee replacement. Dr. Cien is not affiliated with the Jiffy Knee program.
Will I have less pain and a faster recovery?
A muscle-sparing approach may result in less pain and faster recovery than a traditional approach.1,2 Individual results vary, and your recovery also depends on your health before surgery and how closely you follow your recovery plan.
What is recovery like?
Most patients go home the same day. Physical therapy usually starts 5 to 10 days after surgery. Most patients drive again in 2 to 6 weeks and return to work at about 6 weeks. Your care team will give you a plan for your own recovery.
Does insurance cover it?
BackInAction Knee is a total knee replacement, which Medicare and most insurance plans cover when it is medically necessary. Our office checks your coverage before surgery.
Am I a candidate?
It depends on your knee. Dr. Cien will examine your knee and review your imaging to decide whether a muscle-sparing approach is right for you.
How do I make an appointment?
Call (574) 247-5164 or request an appointment online. Dr. Cien sees patients in South Bend, Mishawaka, Plymouth and Elkhart.
All surgery carries risk. Recovery and results vary. Revision surgery may be required. See your orthopaedic surgeon to discuss your potential benefits and risks. Important safety information about knee replacement
REFERENCES
- Stubnya BG, Kocsis K, Váncsa S, et al. Subvastus Approach Supporting Fast-Track Total Knee Arthroplasty Over the Medial Parapatellar Approach: A Systematic Review and Network Meta-Analysis. J Arthroplasty. 2023 Dec;38(12):2750-2758. doi.org/10.1016/j.arth.2023.06.004
- Liu HW, Gu WD, Xu NW, Sun JY. Surgical approaches in total knee arthroplasty: a meta-analysis comparing the midvastus and subvastus to the medial peripatellar approach. J Arthroplasty. 2014 Dec;29(12):2298-2304. doi.org/10.1016/j.arth.2013.10.023
- Fan, et al. Journal of Orthopaedic Surgery and Research (2026) 21:81. Comparison of robot-assisted modified subvastus approach versus medial parapatellar approach in total knee arthroplasty: a retrospective cohort study.
- Patel, et al. (Malkani) AAOS 2026. Results of Subvastus Approach in Patients Undergoing Primary Robotic-Assisted Cementless TKA: a review of 1,419 cases.
Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: BackInAction, Mako, SmartRobotics, Stryker. All other trademarks are trademarks of their respective owners or holders.
Jiffy Knee™ is a trademark of its owner. Dr. Adam Cien and South Bend Orthopaedics are not affiliated with, endorsed by, or trained through the Jiffy Knee program.
