More familiar to most surgeons

Easier and quicker exposure in standard TKA cases

Higher postoperative KSS and ROM (though differences are minimal)

Comparable surgical time to the lateral approach

Reliable correction of valgus deformity

Requires extensive medial release, which may lead to instability

Risk of overcorrection or residual valgus

Less effective in restoring the anatomical axis in some cases (accurate restoration only in 22–30%)

Possible increased risk of peroneal nerve palsy

Better access to contracted lateral structures (IT band, posterolateral capsule)

More anatomical restoration of knee alignment

Less risk of overcorrection or medial instability

Avoids excessive medial release

Technically more challenging

Longer learning curve for surgeons

Higher risk of patellar tracking issues

May require tibial tubercle osteotomy or quadriceps snip for exposure in severe valgus knees

Higher rates of intraoperative fractures and patellar complications