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pear to convey any clinical advantage in this study over conventional approaches for primary TKR. There is little difference in PROMs between the various surgical approaches in TKR with all resulting in good outcomes. However, the conventional midvastus approach (used in 3% of cases) was associated with a 20% reduced risk of revision surgery compared to the most commonly used knee approach (the conventional medial parapatellar used in 91.9% of cases). This data supports the use of the midvastus approach and thus surgeons should consider