Utilizing Unicompartmental Knee Arthroplasty for More than One Compartment

  • Brian Darrith
  • Jeffery H. DeClaire
  • Nicholas B. FrischEmail author


Unicompartmental knee arthroplasty can involve any of the three knee compartments, namely, the medial, lateral, or patellofemoral, and is an excellent option for patients with relative preservation of the remaining two compartments. Traditionally, total knee arthroplasty has been the surgical treatment of choice for patients with symptomatic arthritis involving more than one compartment. There is evidence that modular bicompartmental knee arthroplasty, replacing two compartments with two separate unicompartmental implants and preserving the natural anatomy of the third compartment is a reasonable alternative to total knee arthroplasty in these patients. The purpose of the current discussion is to present the available evidence regarding bicompartmental knee arthroplasty.


Unicompartmental knee arthroplasty Partial knee arthroplasty Bicompartmental knee arthroplasty Patellofemoral knee arthroplasty 


  1. 1.
    Diduch DR, Insall JN, Scott WN, Scuderi GR, Font-Rodriguez D. Total knee replacement in young, active patients. Long-term follow-up and functional outcome. J Bone Joint Surg Am. 1997;79(4):575–82.PubMedCrossRefGoogle Scholar
  2. 2.
    Kelly MA, Clarke HD. Long-term results of posterior cruciate-substituting total knee arthroplasty. Clin Orthop Relat Res. 2002;404:51–7.CrossRefGoogle Scholar
  3. 3.
    Long WJ, Bryce CD, Hollenbeak CS, Benner RW, Scott WN. Total knee replacement in young, active patients: long-term follow-up and functional outcome: a concise follow-up of a previous report. J Bone Joint Surg Am. 2014;96(18):e159.PubMedCrossRefGoogle Scholar
  4. 4.
    Sando T, McCalden RW, Bourne RB, MacDonald SJ, Somerville LE. Ten-year results comparing posterior cruciate-retaining versus posterior cruciate-substituting total knee arthroplasty. J Arthroplast. 2015;30(2):210–5.CrossRefGoogle Scholar
  5. 5.
    Ranawat CS, Flynn WF Jr, Saddler S, Hansraj KK, Maynard MJ. Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study. Clin Orthop Relat Res. 1993;286:94–102.Google Scholar
  6. 6.
    Hartley RC, Barton-Hanson NG, Finley R, Parkinson RW. Early patient outcomes after primary and revision total knee arthroplasty. A prospective study. J Bone Joint Surg. 2002;84(7):994–9.CrossRefGoogle Scholar
  7. 7.
    Reinhardt KR, Huffaker SJ, Thornhill TS, Scott RD. Cruciate-retaining TKA is an option in patients with prior patellectomy. Clin Orthop Relat Res. 2015;473(1):111–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467(10):2606–12.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Clement ND, Macdonald D, Patton JT, Burnett R. Post-operative Oxford knee score can be used to indicate whether patient expectations have been achieved after primary total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014;23(6):1578–90.PubMedCrossRefGoogle Scholar
  10. 10.
    Parvizi J, Nunley RM, Berend KR, Lombardi AV Jr, Ruh EL, Clohisy JC, Hamilton WG, Della Valle CJ, Barrack RL. High level of residual symptoms in young patients after total knee arthroplasty. Clin Orthop Relat Res. 2014;472(1):133–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468(1):57–63.PubMedCrossRefGoogle Scholar
  12. 12.
    Komistek RD, Allain J, Anderson DT, Dennis DA, Goutallier D. In vivo kinematics for subjects with and without an anterior cruciate ligament. Clin Orthop Relat Res. 2002;404:315–25.CrossRefGoogle Scholar
  13. 13.
    Grood ES, Suntay WJ, Noyes FR, Butler DL. Biomechanics of the knee-extension exercise. Effect of cutting the anterior cruciate ligament. J Bone Joint Surg Am. 1984;66(5):725–34.PubMedCrossRefGoogle Scholar
  14. 14.
    Amis AA, Scammell BE. Biomechanics of intra-articular and extra-articular reconstruction of the anterior cruciate ligament. J Bone Joint Surg. 1993;75(5):812–7.CrossRefGoogle Scholar
  15. 15.
    Swanik CB, Lephart SM, Rubash HE. Proprioception, kinesthesia, and balance after total knee arthroplasty with cruciate-retaining and posterior stabilized prostheses. J Bone Joint Surg Am. 2004.;86-A;86(2):328–34.PubMedCrossRefGoogle Scholar
  16. 16.
    Andriacchi TP, Dyrby CO. Interactions between kinematics and loading during walking for the normal and ACL deficient knee. J Biomech. 2005;38(2):293–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Watanabe T, Abbasi AZ, Conditt MA, Christopher J, Kreuzer S, Otto JK, Banks SA. In vivo kinematics of a robot-assisted uni- and multi-compartmental knee arthroplasty. J Orthop Sci. 2014;19(4):552–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Wunschel M, Lo J, Dilger T, Wulker N, Muller O. Influence of bi- and tri-compartmental knee arthroplasty on the kinematics of the knee joint. BMC Musculoskelet Disord. 2011;12:29.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Kamath AF, Levack A, John T, Thomas BS, Lonner JH. Minimum two-year outcomes of modular bicompartmental knee arthroplasty. J Arthroplast. 2014;29(1):75–9.CrossRefGoogle Scholar
  20. 20.
    Parratte S, Ollivier M, Opsomer G, Lunebourg A, Argenson JN, Thienpont E. Is knee function better with contemporary modular bicompartmental arthroplasty compared to total knee arthroplasty? Short-term outcomes of a prospective matched study including 68 cases. Orthop Traumatol Surg Res. 2015;101(5):547–52.PubMedCrossRefGoogle Scholar
  21. 21.
    Kooner S, Johal H, Clark M. Bicompartmental knee arthroplasty vs total knee arthroplasty for the treatment of medial compartment and patellofemoral osteoarthritis. Arthroplast Today. 2017;3(4):309–14.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Engh GA, Parks NL, Whitney CE. A prospective randomized study of bicompartmental vs. total knee arthroplasty with functional testing and short term outcome. J Arthroplast. 2014;29(9):1790–4.CrossRefGoogle Scholar
  23. 23.
    Yeo NE, Chen JY, Yew A, Chia SL, Lo NN, Yeo SJ. Prospective randomised trial comparing unlinked, modular bicompartmental knee arthroplasty and total knee arthroplasty: a five years follow-up. Knee. 2015;22(4):321–7.PubMedCrossRefGoogle Scholar
  24. 24.
    Sabatini L, Giachino M, Risitano S, Atzori F. Bicompartmental knee arthroplasty. Ann Transl Med. 2016;4(1):5.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Shah SM, Dutton AQ, Liang S, Dasde S. Bicompartmental versus total knee arthroplasty for medio-patellofemoral osteoarthritis: a comparison of early clinical and functional outcomes. J Knee Surg. 2013;26(6):411–6.PubMedCrossRefGoogle Scholar
  26. 26.
    Benazzo F, Rossi SM, Ghiara M. Partial knee arthroplasty: patellofemoral arthroplasty and combined unicompartmental and patellofemoral arthroplasty implants–general considerations and indications, technique and clinical experience. Knee. 2014;21(Suppl 1):S43–6.PubMedCrossRefGoogle Scholar
  27. 27.
    Biazzo A, Silvestrini F, Manzotti A, Confalonieri N. Bicompartmental (uni plus patellofemoral) versus total knee arthroplasty: a match-paired study. Musculoskelet Surg. 2018;103(1):63–8.PubMedCrossRefGoogle Scholar
  28. 28.
    Ogura T, Le K, Merkely G, Bryant T, Minas T. A high level of satisfaction after bicompartmental individualized knee arthroplasty with patient-specific implants and instruments. Knee Surg Sports Traumatol Arthrosc. 2018;27(5):1487–96.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Tamam C, Plate JF, Augart M, Poehling GG, Jinnah RH. Retrospective clinical and radiological outcomes after robotic assisted bicompartmental knee arthroplasty. Adv Orthop. 2015;2015:747309.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Alnachoukati OK, Barrington JW, Berend KR, Kolczun MC, Emerson RH, Lombardi AV Jr, Mauerhan DR. Corrigendum to ‘eight hundred twenty-five medial mobile-bearing unicompartmental knee arthroplasties: the first 10-year US Multi-Center Survival Analysis’ [Journal of Arthroplasty 33 (2018) 677–683]. J Arthroplast. 2018;33(7):2339.CrossRefGoogle Scholar
  31. 31.
    Parratte S, Pauly V, Aubaniac JM, Argenson JN. Survival of bicompartmental knee arthroplasty at 5 to 23 years. Clin Orthop Relat Res. 2010;468(1):64–72.PubMedCrossRefGoogle Scholar
  32. 32.
    Alnachoukati OK, Barrington JW, Berend KR, Kolczun MC, Emerson RH, Lombardi AV Jr, Mauerhan DR. Eight hundred twenty-five medial mobile-bearing unicompartmental knee arthroplaties: the first 10-year US multi-center survival analysis. J Arthroplast. 2018;33(3):677–83.CrossRefGoogle Scholar
  33. 33.
    Confalonieri N, Manzotti A, Cerveri P, De Momi E. Bi-unicompartmental versus total knee arthroplasty: a matched paired study with early clinical results. Arch Orthop Trauma Surg. 2009;129(9):1157–63.PubMedCrossRefGoogle Scholar
  34. 34.
    Tan SM, Dutton AQ, Bea KC, Kumar VP. Bicompartmental versus total knee arthroplasty for medial and patellofemoral osteoarthritis. J Orthop Surg. 2013;21(3):281–4.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Brian Darrith
    • 1
  • Jeffery H. DeClaire
    • 2
  • Nicholas B. Frisch
    • 2
    Email author
  1. 1.Department of Orthopaedic SurgeryRush University Medical CenterChicagoUSA
  2. 2.DeClaire LaMacchia Orthopaedic InstituteRochesterUSA

Personalised recommendations