40 patients undergoing total knee arthroplasty (TKA) were randomized to determine the differences in outcome between the subvastus approach and the parapatellar approach. Clinical outcomes were assessed over 3 months postoperatively, and a blunt anatomical dissection was performed to determine the possible disadvantages of employing either technique. The only significant difference that was observed between the approaches was a significantly lower number of patients with extension lag when treated with the subvastus approach. However, the study indicated that the dense innervation of the distal vastus medialis is at higher risk of damage when using the subvastus approach.