Evolving indications for partial knee replacement : New aspects

Abstract

Partial knee replacement has proven to be an effective therapy for advanced unicompartmental arthrosis of the knee. Despite continuous advancements in implants and surgical techniques over the past decades, the global preference for total knee arthroplasty still persists for historical reasons. This report aims to illuminate advantages and disadvantages of partial knee replacement considering long-term results, the evolution of indication criteria over recent decades and new aspects in patient selection with potential improvements through emerging technologies. The analysis involves the examination of long-term results from clinical studies and registry data, highlighting the risk factors for potential failures and their influence on the development of indication criteria. Present-day long-term results demonstrate excellent prosthetic survival, aligning with outcomes from total knee arthroplasty. New perspectives for expanding indication criteria are discussed, including the possible application of partial knee replacement in cases of severe varus deformity > 15°, anterior cruciate ligament insufficiency, young active patients, anterior knee pain, and/or patellofemoral arthritis, as well as mild radiographic arthritis with degenerative medial meniscus root tear and meniscal extrusion. Indication criteria have consistently expanded in recent years, taking into account modern insights, and the application of advanced technologies can enhance precision and minimize surgical errors. Furthermore, this report emphasizes that revision rates are not the sole criterion for success and underscores the necessity for acomprehensive examination of clinical results.