With the growing demand for total knee arthroplasty (TKA) in patients with end-stage knee osteoarthritis, the integration of minimally invasive surgical concepts with high-conformity personalized prosthesis design has become an important strategy for improving surgical precision and postoperative outcomes. However, standardized clinical pathway guidance for this combined approach remains lacking. Therefore, based on the current body of evidence and through multicenter expert collaboration, this consensus aims to establish a standardized clinical application protocol. The consensus focuses on the technical characteristics of high-conformity prostheses and the principles of mechanical alignment, and systematically develops a comprehensive clinical pathway covering preoperative digital planning, intraoperative precision techniques, and postoperative rehabilitation and follow-up. By standardizing patient selection criteria, refining imaging-based modeling and individualized prosthesis design procedures, optimizing osteotomy accuracy and soft tissue preservation under minimally invasive conditions, and establishing a follow-up system centered on functional baseline comparison and image-based matching verification, this consensus ultimately proposes a closed loop quality management framework spanning preoperative assessment, intraoperative implementation, and postoperative evaluation. It is expected to provide practical guidance for the safe and effective clinical application of high-conformity TKA performed through minimally invasive approaches.