Indikationen und Kontraindikationen zum medialen Schlitten

Despite its potential advantages, unicondylar knee arthroplasty (UKA) is still rarely used compared to total knee arthroplasty (TKA). Higher patient satisfaction with UKA is generally offset by higher revision rates compared to TKA. The surgeon’s routine is of decisive importance for a successful outcome, particularly when performing UKA. Furthermore, old “dogmas” regarding indications and contraindications persist. In this paper, the indications and contraindications for UKA are presented with special consideration of the factors influencing the clinical outcome and reasons for revision. According to the literature data, advanced arthrosis of the contralateral tibiofemoral and the contralateral patellofemoral joint section as well as instability of the collateral ligaments and the posterior cruciate ligament are the only clear contraindications. On the other hand, an increased body mass index, age, condrocalcinosis, anterior knee pain with patellofemoral cartilage damage and a defective (but in particular functionally stable) anterior cruciate ligament are not clear contraindications. However, as with situations after osteotomy and existing rheumatic diseases, the indication should be considered critically in order to avoid failure. In principle, sporting activities no longer need to be restricted. The use of mobile and fixed inlays should be considered equivalent. The cementless procedure with a mobile inlay appears to lead to a lower rate of loosening in overweight patients compared to cemented implant fixation.