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Unicompartmental knee arthroplasty: state of the art
  1. Laura J Kleeblad1,
  2. Hendrik A Zuiderbaan2,
  3. Gary J Hooper3,
  4. Andrew D Pearle1
  1. 1 Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York, USA
  2. 2 Department of Orthopaedic Surgery, Medisch Centrum Alkmaar, Alkmaar, The Netherlands
  3. 3 Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch, New Zealand
  1. Correspondence to Dr Laura J Kleeblad, Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Hospital for Special Surgery, Weill Medical College of Cornell University, 535 East 70th Street, New York, NY 10021, USA; kleebladl{at}


The popularity of unicompartmental knee arthroplasty (UKA) for the treatment of isolated compartment osteoarthritis of the knee has risen over the past 2 decades. Currently, UKA covers 10% of all knee arthroplasties worldwide. Although indications have been extended, results have proven that patient selection plays a critical role in the success of UKA. From the current perspective, age, body mass index, patellofemoral osteoarthritis, anterior cruciate ligament deficiency and chondrocalcinosis are no longer absolute contraindications for UKA. Motivated by the desire to improve survivorship rates, patient-reported outcomes and reduce complications, there have been many technological advances in the field of UKA over the recent years. The aim of this review was to evaluate the current indications, surgical techniques, modes of failure and survivorship results of UKA, by assessing a thorough review of modern literature. Several studies show that innovations in implant design, fixation methods and surgical techniques have led to good-to-excellent long-term survivorship, functional outcomes and less complications. Until now, resurgence of interest of cementless designs is noted according to large national registries to address problems associated with cementation. The future perspective on the usage of UKA, in particular the cementless design, looks promising. Furthermore, there is a growing interest in robotic-assisted techniques in order to optimise result by controlled soft-tissue balancing and reproduce alignment in UKA. Future advances in robotics, most likely in the field of planning and setup, will be valuable in optimising patient-specific UKA.

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  • Contributors The authors confirm that the manuscript has been read and approved by all the named authors. LJK was the leading author of the manuscript under the supervision of ADP. All authors have contributed to the writing process by means of specific perspectives on surgical techniques, geographical differences and future innovations. Furthermore, the article has been revised by the other authors a couple of times (HAZ, GJH and ADP).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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