Objective:

To explore the evolution, current debates, and future trends in unicompartmental knee arthroplasty (UKA) for isolated compartment osteoarthritis.

Approach:

• Evolution of UKA: UKA has transitioned from a selective procedure to a versatile solution for isolated compartment osteoarthritis.
• Personalized Medicine: UKA exemplifies individualized knee arthroplasty, preserving native knee structures and offering tailored solutions.
• Contemporary Evidence: Recent studies indicate satisfactory outcomes for UKA in early-stage osteoarthritis, challenging traditional patient selection criteria.
• Technical Demands: UKA requires precision in implant positioning to avoid complications, with alignment being critical.
• Technological Advancements: Robotic and navigation-assisted techniques enhance surgical accuracy and anatomical restoration.
• Implant Design Debate: No clear superiority between cemented vs. cementless fixation; selection should be patient-specific.
• Infection Risk: UKA has a lower risk of periprosthetic joint infection compared to TKA, but infection management remains challenging.
• Functional Biomechanics: Research highlights persistent alterations in gait and loading patterns post-UKA despite favorable clinical scores.

Key Findings:

• UKA preserves native knee anatomy and biomechanics, offering a more physiological reconstruction.
• Contemporary evidence supports broader indications for UKA beyond traditional criteria.
• Technological innovations are key to improving surgical accuracy in UKA.
• UKA is associated with a lower risk of infection compared to TKA.

Interpretation:

Limitations:

• UKA remains technically demanding, requiring high precision in surgical technique.
• The learning curve for surgeons can impact outcomes, necessitating structured training.

Conclusion:

UKA is evolving as a personalized approach to knee arthroplasty, with ongoing debates about techniques, implant design, and patient selection.