Personalized Revision Arthroplasty After Failed Medial Unicompartmental Knee Arthroplasty: A Contemporary Narrative Review
- 1Orthopaedic and Trauma Department, Żeromski Specialist Hospital, Osiedle Na Skarpie 66, 31-913 Kraków, Poland
- 2Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
Abstract
Medial unicompartmental knee arthroplasty (UKA) is a bone- and ligament-preserving alternative to total knee arthroplasty (TKA) for selected patients with isolated medial compartment osteoarthritis, but it carries a consistently higher revision rate. The assumption that a failed UKA converts easily to a primary-standard TKA has not survived registry scrutiny, and conversion is now best regarded as a formal revision procedure. This contemporary narrative review, which is not a systematic review, evaluates revision strategies after failed medial UKA. Sources were identified through targeted literature searches and reference-list screening, and the strength of evidence was graded by level of evidence. Three pathways are considered: revision within the medial compartment, including bearing and single-component exchange; retention of a well-fixed, well-positioned medial UKA with addition of a patellofemoral arthroplasty or a lateral UKA; and conversion to TKA. Evidence quality differs sharply between pathways. Conversion to TKA is supported by registry and comparative cohort data, and medial UKA-to-UKA revision mainly by evidence of its high failure rate. Compartmental addition rests on one small dedicated series, one small multicentre comparative study, one descriptive multicentre series, one expert consensus and indirect data from primary bicompartmental arthroplasty. A four-step framework is proposed (failure mechanism, compartmental mapping, bone and ligament assessment, patient and centre factors); it is evidence-informed but not validated.
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BibTeX
@article{skowronek2026personalized,
title = {{Personalized Revision Arthroplasty After Failed Medial Unicompartmental Knee Arthroplasty: A Contemporary Narrative Review}},
author = {Paweł Skowronek and Adam Smolik and Filip Skowronek and Łukasz Dutka and Maria R. Skowronek and Klaudia Joniak and Michał J. Skowronek},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218577},
url = {https://www.mdpi.com/2077-0383/15/21/8577},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Personalized Revision Arthroplasty After Failed Medial Unicompartmental Knee Arthroplasty: A Contemporary Narrative Review
AU - Paweł Skowronek
AU - Adam Smolik
AU - Filip Skowronek
AU - Łukasz Dutka
AU - Maria R. Skowronek
AU - Klaudia Joniak
AU - Michał J. Skowronek
PY - 2026
DA - 2026/11/03
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218577
UR - https://www.mdpi.com/2077-0383/15/21/8577
AB - Medial unicompartmental knee arthroplasty (UKA) is a bone- and ligament-preserving alternative to total knee arthroplasty (TKA) for selected patients with isolated medial compartment osteoarthritis, but it carries a consistently higher revision rate. The assumption that a failed UKA converts easily to a primary-standard TKA has not survived registry scrutiny, and conversion is now best regarded as a formal revision procedure. This contemporary narrative review, which is not a systematic review, evaluates revision strategies after failed medial UKA. Sources were identified through targeted literature searches and reference-list screening, and the strength of evidence was graded by level of evidence. Three pathways are considered: revision within the medial compartment, including bearing and single-component exchange; retention of a well-fixed, well-positioned medial UKA with addition of a patellofemoral arthroplasty or a lateral UKA; and conversion to TKA. Evidence quality differs sharply between pathways. Conversion to TKA is supported by registry and comparative cohort data, and medial UKA-to-UKA revision mainly by evidence of its high failure rate. Compartmental addition rests on one small dedicated series, one small multicentre comparative study, one descriptive multicentre series, one expert consensus and indirect data from primary bicompartmental arthroplasty. A four-step framework is proposed (failure mechanism, compartmental mapping, bone and ligament assessment, patient and centre factors); it is evidence-informed but not validated.
SN - 2077-0383
ER -