minimally invasive surgery is a concept well known in medicine – In orhotpedic surgery the advent of arthroscopic techniques has given a dramatic change in clinical and surgical approach. Total knee replacement (TKR) is a well established procedure. Good result have been widely documented. Nevertheless wide surgical approach, the post op. pain, the lenght of hospitalization, the rehabilitation program are still long and heavy for the patient. Minimally invasive procedure consist in a new way of approaching the surgical intervention in TKR, riducing the lenght of the incision, minimizing the soft tissue thrauma, sparing as much as possible the extensor mechanism. This new approach has brougt to a change also in instruments design. This is a new technique and we don’t have statistically significative data. We rely upon data from authors like Tria and the clinic results of our cases We can affirm that minimally invasive techniques in TKR permits a lower level of post op. pain and bleeding, shorter lenght of hospital admission time, faster rehabilitation