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Online ISSN 1827-1707
Swienckowski J. J. 1, Bono F. S. 1, Spagnuolo M. W. 2
1 College of Osteopathic Medicine Michigan State University Botsford General Hospital, Farmington Hills, MI, USA
2 Unit of Orthopedic Sugery Botsford General Hospital Farmington Hills, MI, USA
Unicompartmental knee arthroplasty (UKA) for single compartment non-inflammatory arthritis has been termed “controversial” since its inception in the early 1970’s. A critical review of the negative articles on UKA, reveals that inappropriate patient selection, suboptimal surgical technique and inferior implant design were major contributors to those poor results. Concomitant improvements in high tibial osteotomy (HTO) and total knee arthroplasty (TKA) placed a damper on any enthusiasm for UKA in the United States. This was despite satisfactory early reports both here and abroad. Those surgeons who continued to perform UKA observed the development of proper indications, contra-indications, patient selection criteria, and improvements in instrumentation and surgical techniques. However, these criteria are not universally accepted. Many issues including ease of revision, appropriate patient weight and age, and the amount of acceptable arthritis in the non-operative compartments are still debated. Minimally invasive surgery (MIS) for UKA, and published long-term survivorship indicating good-to-excellent results, has created renewed interest in UKA. MIS has also raised concerns regarding implant position and alignment. A solution may have appeared with computer assisted orthopedic surgery (CAOS). These image and non-image-based navigation systems have shown promise aiding in the positioning of UKA components in the most desired position and improving the accuracy of limb alignment. If properly performed UKA is a reliable and durable method of treating single compartment gonarthrosis with high degrees of patient satisfaction.