One hundred and eighty-nine patients with knee osteoarthritis scheduled for a minimally-invasive total knee arthroplasty were randomized to receive osteophyte removal and soft tissue balancing with the patella reduced (n=93) or the patella subluxated (n=96). Outcomes of interest included gap and varus angle in extension and flexion, prosthesis alignment, Knee Society Scores (KSS), pain on a Visual Analog Scale (VAS), and range of motion. Follow-up was 12 months. Results revealed that flexion gap and varus angle were significantly greater after patella reduction than before reduction in the subluxation group. Moreover, the femoral prosthesis tended to be internally rotated in the subluxation group. The reduction group displayed superior VAS pain scores and range of motion at 1 month vs. the subluxation group.