Avoiding complications in medial unicompartmental knee arthroplasty

Medial unicompartmental knee arthroplasty (mUKA) is a highly effective treatment for the management of isolated osteoarthritis in the medial compartment. While favorable long-term survivorship is seen in most series, the long-term rate of revision after mUKAs remains higher than that for total knee arthroplasty. Poor indications and poor surgical technique are often responsible for mUKA failure. Understanding why these complications occur and how to avoid them will optimize clinical outcomes, reduce revision rates, and lead to lower healthcare costs. This review will discuss the five most common causes of mUKA failure including progression of arthritis, aseptic loosening, bearing dislocation, periprosthetic fracture, and polyethylene wear and how to avoid them with proper patient selection and meticulous surgical technique.