Clinical outcome of bi-unicompartmental knee arthroplasty for both medial and lateral femorotibial arthritis: a systematic review-is there proof of concept?

Keizo Wada, Andrew Price, Kirill Gromov, Sebastien Lustig, Anders Troelsen

9 Citations (Scopus)


INTRODUCTION: Unicompartmental knee arthroplasty (UKA) is a well-accepted treatment for isolated unicompartmental osteoarthritis (OA) of the knee. In previous literature, it has been suggested that bi-unicompartmental knee arthroplasty (bi-UKA) which uses two UKA implants in both the medial and lateral compartments of the same knee is a feasible and viable option for the treatment of knee OA. Given the advantages of UKA treatment, it is warranted to review the literature of bi-UKA and discuss the evidence in terms of implant selection, indications, surgical techniques, and outcomes, respectively.

MATERIALS AND METHODS: Following the PRISMA guidelines, PubMed, Medline, Embase, CINAHL, Web of Science, and Cochrane Library were searched for studies presenting outcome of bi-UKA. Studies were included if they reported clinical outcomes using two unicompartmental prostheses for both medial and lateral femorotibial arthritis. Studies with the addition of patellofemoral arthroplasty or concomitant soft-tissue reconstruction and those not published in English were excluded.

RESULTS: In the early literature, the procedure of bi-UKA were performed for very severe OA and rheumatoid arthritis, but indications have evolved to reflect a more contemporary case-mix of knee OA patients. Both mobile and fixed bearing implants have been used, with the latter being the most frequent choice. A medial parapatellar approach for incision and arthrotomy has been the most frequently used technique. The present review found a promising clinical outcome of both simultaneous and staged bi-UKA although the number of long-term follow-up studies was limited.

CONCLUSIONS: Both simultaneous and staged bi-UKA has demonstrated good functional outcomes. However, the volume and level of evidence in general is low for studies captured in this review, and the data on long-term outcomes remain limited. The present review indicates that bi-UKA is a feasible and viable surgical option for bicompartmental femorotibial OA in carefully selected patients.

Original languageEnglish
JournalArchives of Orthopaedic and Trauma Surgery
Issue number10
Pages (from-to)1503-1513
Number of pages11
Publication statusPublished - Oct 2020


  • Arthroplasty
  • Bi-unicompartmental knee arthroplasty
  • Knee
  • Osteoarthritis
  • Unicompartmental knee arthroplasty
  • Osteoarthritis, Knee/surgery
  • Knee Joint/surgery
  • Humans
  • Arthroplasty, Replacement, Knee
  • Treatment Outcome


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