27 patients undergoing bilateral total knee arthroplasty (54 knees) were collectively enrolled in this study. Each patient was randomly selected to receive a mini-midvastus procedure on one knee, and a standard medial parapatellar procedure on the other. The results confirmed there were no significant differences in outcome between the mini-midvastus and standard approach based on stride length, stance time, visual analogue scale (VAS) pain scores or knee range motion. The sole significant difference was evident during quadricep strength testing at 3 weeks postoperative, but diminished by week 6. In sum, when compared to the standard TKA procedure, the min-midvastus approach offered few benefits. Further evaluations are required to expand on this short term evidence and provide long-term comparisons.