Recommendations for unicondylar knee replacement in the course of time A current inventory

Background A higher patient satisfaction stands in contrast to higher revision rates of unicondylar knee joint endoprosthetics (UKE) compared to total knee joint endoprosthetics (TKE). Furthermore, old dogmas regarding indications and contraindications persist, which is still reflected in the significantly different case numbers. Aim The aim of this article is to provide an overview of the current literature regarding 1. indication and contraindication (BMI, age, sport, arthrosis of other compartments, ligament status) and 2. the eternal rival fixed or mobile bearing for UKE. Results The choice of the right patient remains essential, even if all the old dogmas of contraindications have been relativized or even outdated. Arthroses of the contralateral (in medial UKE correspondingly lateral) compartment and advanced arthroses of the lateral patella facet remain the only persistent contraindications. In contrast, a high BMI, age, chondrocalcinosis, medial patella facet and a defective (but particularly functionally stable) ACL are not contraindications; however, severe obesity is responsible for a significantly higher complication rate and probably a higher rate of loosening. Rather, the experience and thus the number of UKEs of the individual surgeon is decisive for the outcome, to which the discussion about mobile or fixed inlays must also be completely subordinated. Conclusion The indications for UKE can, therefore, be extended with a clear conscience on the basis of literature, and the current 1:10 UKE:TKE ratio in Germany can be shifted significantly.

Automated summary

It is crucial to choose the right patient for unicondylar knee joint endoprosthetics (UKE), with old dogmas regarding contraindications being relativized. The indications for UKE can be extended based on current literature, with the experience of the individual surgeon playing a decisive role in the outcome.