MIS Unicondylar Arthroplasty: The Bone-Sparing Technique

  • John A. Repicci
  • Jodi F. Hartman


Minimally invasive (MIS) unicondylar knee arthroplasty (UKA) and total knee arthroplasty (TKA) each have specific indications and distinctive roles in the senior author’s algorithm for the treatment of knee osteoarthritis (OA). MIS UKA is not a substitute for TKA, which is the procedure of choice for treatment of advanced stages of OA. This philosophy is supported by Thornhill and Scott, who assert that UKA should be considered in the “continuum of surgical options for the treatment of the osteoarthritic patient.”1 In cases of earlier, nonadvanced OA, the two procedures may act in conjunction with one another, with MIS UKA serving as a supplement to future TKA. Together, these devices may be considered as a “knee prosthetic system.”2

With the limited survivorship of TKA and the aging of the active baby boomer population, there is a need for a procedure in addition to TKA to address the treatment of earlier, nonadvanced stages of OA and to extend the survivability of knee prosthetics. Because knee prosthetics have a finite life span, a single device cannot encompass the entire spectrum of survivability necessary for many patients. Under the senior author’s serial replacement concept, a procedure such as MIS UKA performed at an earlier age, before TKA use and as a supplement to TKA, will absorb approximately 10 years of functional capacity so that when and if future arthroplasty is required, the survivability of the entire knee prosthetic system is lengthened.2,3 By following this philosophy, the use of MIS UKA in conjunction with a future TKA may increase the functional capacity of the entire knee prosthetic system to 20–30 years. The fundamental goal of this serial prosthetic replacement is to decrease the likelihood of a complex revision procedure in the patient’s lifetime.


Total Knee Arthroplasty Femoral Component Femoral Condyle Primary Total Knee Arthroplasty Unicondylar Knee Arthroplasty 
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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Joint Reconstruction Orthopedic CenterBuffaloUSA

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