44 patients scheduled for simultaneous bilateral total knee arthroplasty had knees randomized to either lateral retraction of the patella or eversion of the patella. The purpose of this study was to compare functional recovery between knees, through performance-based measures and range of motion. Outcomes were assessed during hospitalization and over a 1-year follow-up. For performance-based measures, lateral retraction demonstrated a significantly shorter time to achieve the straight leg raise test compared to eversion, though no significant difference was observed in time to achieve 90 degrees knee flexion. Active and passive range of motion were also significantly greater following lateral retraction up to 1 year postoperatively.