This prospective case series reports 10- to 13-year outcomes of cemented modular Miller-Galante UKA in 62 knees at a single academic center. It addresses whether UKA provides durable results beyond a decade with current implant designs and strict selection criteria.
UKA had fallen out of favor after early discouraging reports, but this paper — using strict Kozinn-Scott criteria and intentional varus undercorrection — demonstrated that modern cemented UKA is genuinely durable at a decade.
The selection rules here are the ones to know: exclude anyone with patellofemoral symptoms, a positive patellar grind test, or Outerbridge Grade 3–4 changes in any compartment found at the time of surgery. If you find Grade 3–4 disease intraoperatively, convert to TKA.
When you correct varus deformity at UKA, leave a small residual varus (target ~2°). Overcorrecting shifts load to the uninvolved compartment and accelerates its degeneration — this is the biomechanical rationale behind undercorrection.
If a UKA fails, the conversion to TKA is straightforward provided bone resection was conservative at the index case. Both revisions in this series used standard primary implants without augmentation — a strong argument for UKA as a bone-preserving first step in the appropriately selected patient.
This prospective case series reports 10- to 13-year outcomes of cemented modular Miller-Galante UKA in 62 knees at a single academic center. It addresses whether UKA provides durable results beyond a decade with current implant designs and strict selection criteria.
UKA had fallen out of favor after early discouraging reports, but this paper — using strict Kozinn-Scott criteria and intentional varus undercorrection — demonstrated that modern cemented UKA is genuinely durable at a decade.
The selection rules here are the ones to know: exclude anyone with patellofemoral symptoms, a positive patellar grind test, or Outerbridge Grade 3–4 changes in any compartment found at the time of surgery. If you find Grade 3–4 disease intraoperatively, convert to TKA.
When you correct varus deformity at UKA, leave a small residual varus (target ~2°). Overcorrecting shifts load to the uninvolved compartment and accelerates its degeneration — this is the biomechanical rationale behind undercorrection.
If a UKA fails, the conversion to TKA is straightforward provided bone resection was conservative at the index case. Both revisions in this series used standard primary implants without augmentation — a strong argument for UKA as a bone-preserving first step in the appropriately selected patient.