300 patients with primary osteoarthritis undergoing total knee arthroplasty were randomized to evaluate the effectiveness of reduced soft tissue and muscle damage during TKA in improving recovery and other outcomes over 24 months, compared to the conventional technique. Patients were evaluated using the Knee Society Score (KSS), visual analogue scale (VAS) for pain, flexion, blood loss, length of stay and alignment. The evidence presented in this study revealed that the minimally invasive limited parapatellar approach with medial collateral ligament conservation resulted in faster recovery in the early postoperative period, along with reduced pain, length of stay and bleeding and improved flexion, when compared to the conventional technique. No malalignments or complications were observed in either procedure.