“…The changes in patellar tracking with time with the MPP approach are an important concern for many orthopaedic surgeons [15,20,22,26]. As a result, they use the MV approach instead of the MPP approach in conventional TKAs [8,9,17,31]. The extensor mechanism suffers less damage and the patella is not everted in a MIS TKA, which would result in good patellar tracking and lower incidence of anterior knee pain.…”