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Ideal alignment for UKA: are we any closer?
  1. David Parker1,2
  1. 1 Sydney Orthopaedic Research Institute, Chatswood, New South Wales, Australia
  2. 2 University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Associate Professor David Parker, Sydney Orthopaedic Research Institute, Chatswood, NSW 2067, Australia; dparker{at}

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The recently published article by Petterson et al 1 questions the role of alignment in outcomes after medial unicompartmental knee arthroplasty (UKA). In this review the authors select a series of articles to review, in order to provide improved clarity around guidelines for the ideal alignment to aim for when performing UKA. The authors also have the additional related aim of providing clearer guidelines for the degree of preoperative deformity that can be accepted when performing UKA. There is a disparity of opinion within the orthopaedic community as to the indications for UKA, with some authors advocating that up to 50% of arthroplasty patients are suitable,2 while others advocate almost exclusive use of total knee replacement (TKR). Given this disparity, a review can be helpful in clarifying indications and utilisation of this procedure.

The authors quote the rates of UKA being 8%–15% of all arthroplasty. This figure is quoted from a UK paper from 2009,2 and this figure has fluctuated since that time, varying widely around the world and also between centres within the same country. UKA ‘enthusiasts’ will see broader indications, and for example in some regions in Europe higher rates of utilisation are seen. In Australia, the 2019 National Joint Registry Report3 reported a …

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