Bicompartmental (uni plus patellofemoral) versus total knee arthroplasty: a match-paired study

  • A. Biazzo
  • F. Silvestrini
  • A. Manzotti
  • N. Confalonieri
Original Article



Osteoarthritis (OA) of the knee, whether primary or post-traumatic, does not always involve all three compartments (tibiofemoral medial and lateral and the patellofemoral ones). Bicompartmental knee arthroplasty (BKA) was proposed as a good alternative to total knee arthroplasty when two of the three knee compartments were affected.

Materials and methods

We performed a retrospective comparative study collecting all BKAs performed between March 2010 and January 2016. During this period, we treated 27 patients with BKA for medial or lateral and patellofemoral OA. Seven of them were lost to follow-up and were not included in the study. Group A (BKA group) was compared to a homogeneous group of 20 patients who underwent TKA during the same period (group B).


Patients treated with TKA were younger than those treated with BKA (mean age 65 vs. 67.2; p = 0.2149). BKA resulted in longer mean operating time (87 vs. 82.4 min; p = 0.2983), less blood loss (413 vs. 458 ml; p = 0.0052) but higher blood transfusion rate (12 vs. 10%). Medium follow-up was 34 months for BKA group and 38 months for TKA group. No statistically significant differences were found in KSS score between the two groups (KSS score 92.3 for BKA, 94.5 for TKA; p = 0.5221; KSS function was 87.2 for BKA and 89.2 for TKA; p = 0.4985).


The most important finding of the present study was that although BKA seemed to be theoretically more favorable in terms of functional recovery and blood loss, patients of group A had lower KSS score and higher transfusion rate than those of group B. Our data confirm that BKA could be proposed as an alternative to TKA, especially in young and high-demanding patients.


Unicompartmental knee arthroplasty Bicompartmental knee arthroplasty Patellofemoral arthroplasty Match-paired study 


Compliance with ethical standards

Conflict of interest



  1. 1.
    Benazzo F, Rossi SM, Ghiara M (2014) Partial knee arthroplasty: patellofemoral arthroplasty and combined unicompartmental and patellofemoral arthroplasty implants–general considerations and indications, technique and clinical experience. Knee 21(Suppl 1):S43–S46CrossRefPubMedGoogle Scholar
  2. 2.
    Wünschel M, Lo J, Dilger T, Wülker N, Müller O (2011) Influence of bi-and tri-compartmental knee arthroplasty on the kinematics of the knee joint. BMC Musculoskelet Disord 12:29CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Heyse T, Khefacha A, Cartier P (2010) UKA in combination with PFR at average 12-year follow-up. Arch Orthop Trauma Surg 130:1227–1230CrossRefPubMedGoogle Scholar
  4. 4.
    Romagnoli S, Marullo M, Massaro M, Rustemi E, D’Amario F, Corbella M (2015) Bi-unicompartmental and combined uni plus patellofemoral replacement: indications and surgical technique. Joints 3(1):42–48PubMedPubMedCentralGoogle Scholar
  5. 5.
    Morrison TA, Nyce JD, Macaulay WB, Geller JA (2011) Early adverse results with bicompartmental knee arthroplasty: a prospective cohort comparison to total knee arthroplasty. J Arthroplast 26:35–39CrossRefGoogle Scholar
  6. 6.
    Thienpont E, Price A (2013) Bicompartmental knee arthroplasty of the patellofemoral and medial compartments. Knee Surg Sports Traumatol Arthrosc 21(11):2523–2531CrossRefPubMedGoogle Scholar
  7. 7.
    Rolston L, Siewert K (2009) Assessment of knee alignment after bicompartmental knee arthroplasty. J Arthroplasty 24(7):1111–1114CrossRefPubMedGoogle Scholar
  8. 8.
    Palumbo BT, Henderson ER, Edwards PK, Burris RB, Gutietierrez S, Raterman SJ (2011) Initial experience of the journey-deuce bicompartmental knee prosthesis: a review of 36 cases. J Arthroplasty 26(6, supplement):40–45CrossRefPubMedGoogle Scholar
  9. 9.
    Morrison TA, Nyce JD, Macaulay WB, Geller JA (2011) Early adverse results with bicompartmental knee arthroplasty: a prospective cohort comparison to total knee arthroplasty. J Arthroplasty 26(6, supplement):35–39CrossRefPubMedGoogle Scholar
  10. 10.
    Parratte S, Pauly V, Aubaniac JM, Argenson JN (2010) Survival of bicompartmental knee arthroplasty at 5 to 23 years. Clin Orthop Relat Res 468(1):64–72CrossRefPubMedGoogle Scholar
  11. 11.
    Tamam C, Plate JF, Augart M, Poehling GG, Jinnah RH (2015) Retrospective clinical and radiological outcomes after robotic assisted bicompartmental knee arthroplasty. Adv Orthop 2015:747309CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Tan SM, Dutton AQ, Bea KC, Kumar VP (2013) Bicompartmental versus total knee arthroplasty for medial and patellofemoral osteoarthritis. J Orthop Surg (Hong Kong) 21(3):281–284CrossRefGoogle Scholar
  13. 13.
    Chung JY, Min BH (2013) Is bicompartmental knee arthroplasty more favourable to knee muscle strength and physical performance compared to total knee arthroplasty? Knee Surg Sports Traumatol Arthrosc 21(11):2532–2541CrossRefPubMedGoogle Scholar
  14. 14.
    Sabatini L, Schirò M, Atzori F, Ferrero G, Massè A (2016) Patellofemoral joint arthroplasty: our experience in isolated patellofemoral and bicompartmental arthritic knees. Clin Med Insights Arthritis Musculoskelet Disord 15(9):189–193Google Scholar
  15. 15.
    Romagnoli S, Marullo M (2018) Mid-term clinical, functional, and radiographic outcomes of 105 gender-specific patellofemoral arthroplasties, with or without the association of medial unicompartmental knee arthroplasty. J Arthroplasty 33(3):688–695CrossRefPubMedGoogle Scholar
  16. 16.
    Banks SA, Fregly BJ, Boniforti F, Reinschmidt C, Romagnoli S (2005) Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacements. Knee Surg Sports Traumatol Arthrosc 13:551–556CrossRefPubMedGoogle Scholar
  17. 17.
    Confalonieri N, Manzotti A, Cerveri P, De Momi E (2009) Bi-unicompartmental versus total knee arthroplasty: a matched paired study with early clinical results. Arch Orthop Trauma Surg 129(9):1157–1163CrossRefPubMedGoogle Scholar
  18. 18.
    Fuchs S, Tibesku CO, Frisse D, Genkinger M, Laass H, Rosenbaum D (2005) Clinical and functional comparison of uni- and bicondylar sledge prostheses. Knee Surg Sports Traumatol Arthrosc 13:197–202CrossRefPubMedGoogle Scholar
  19. 19.
    Fuchs S, Tibesku CO, Genkinger M, Laass H, Rosenbaum D (2003) Proprioception with bicondylar sledge prostheses retaining cruciate ligaments. Clin Orthop Relat Res 406:148–154CrossRefGoogle Scholar
  20. 20.
    Fuchs S, Tibesku CO, Genkinger M, Volmer M, Laass H, Rosenbaum D (2004) Clinical and functional comparison of bicondylar sledge prostheses retaining all ligaments and constrained total knee replacement. Clin Biomech (Bristol, Avon) 19:263–269CrossRefGoogle Scholar
  21. 21.
    Rolston L, Bresch J, Engh G, Franz A, Kreuzer S, Nadaud M, Puri L, Wood D (2007) Bicompartmental knee arthroplasty: a bone-sparing, ligament-sparing, and minimally invasive alternative for active patients. Orthopedics 30:70–73PubMedGoogle Scholar
  22. 22.
    Confalonieri N, Manzotti A, Montironi F, Pullen C (2008) Tissue sparing surgery in knee reconstruction: unicompartmental (UKA), patellofemoral (PFA), UKA + PFA, bi-unicompartmental (Bi-UKA) arthroplasties. J Orthop Traumatol 9(3):171–177CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Istituto Ortopedico Rizzoli 2018

Authors and Affiliations

  1. 1.Orthopaedic DepartmentHumanitas GavazzeniBergamoItaly
  2. 2.ASST Gaetano Pini-CTOMilanItaly
  3. 3.Orthopaedic DepartmentOspedale Luigi SaccoMilanItaly

Personalised recommendations