Introduction: The aim of the study is to compare the outcomes of arthroplasty performed through medial parapatellar approach versus subvastus with oblique cut approach. Materials and Methodology: After obtaining the permission from the institutional ethical committee, the study was carried out in those patients with osteoarthritis. This study was conducted as a prospective comparative study in assessing the factors influencing the total knee replacement surgeries through medial parapatellar and subvastus oblique approach. A total of 150 patients were included in the study and the proposed study period was about 12 months. Results: A total of 150 patients were included in the study who are all underwent total knee replacement in our study centre and 109 patients were included in group – I that is MP approach (24 males and 85 females) group – II included 41 patients (7 males and 34 females) with the mean age observed at 71.6 ± 6.3 years and 73.3 ± 5.1 years. The preoperative levels of haemoglobin level was observed to be potent significant risk factor as observed in this study which indicated that for every 1 unit rise in Hb, the probability of deferring the transfusion increases by 2.6 times. This result was in concordance with the results obtained from the earlier studies. Conclusion: when comparing the subvastus approach with the medial parapatellar surgical approach in managing the total knee arthroplasty patients, early active straight leg raising for up to over 10 days after the surgical procedure had been reported.