134 patients with symptomatic knee OA, scheduled for total knee arthroplasty, were randomized to the use of either minimally invasive instruments or a standard approach for the TKA procedure. The aim of the study was to compare the clinical outcomes of these two techniques. At 1 year, the minimally invasive surgical technique was not found to provide any substantial benefit, in terms of radiographic results, range of motion, function scores, visual analog pain scores, and activities of daily living, over the conventional approach. It, however, had slightly less blood loss and longer operative time.