128 patients were randomized to determine if there was a difference in short-term pain in minimally invasive total knee arthroplasty with either the quadriceps-sparing subvastus approach or medial parapatellar arthrotomy. Pain outcomes (at rest and during movement) were assessed in the first 3 postoperative days, and narcotic consumption was recorded in-hospital and 8 weeks following discharge. Results indicated that groups did not significantly differ in pain at rest, but pain during activity was significantly lower in patients who were treated with the quadricep-sparing subvastus approach. There was no significant difference in narcotic consumption between groups.