Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain
10.22038/abjs.2025.91153.4129
Abstract
Unicompartmental knee arthroplasty (UKA) is a well-known surgical technique for the management of unicompartmental knee osteoarthritis. There are two basic prosthetic designs for UKA: fixed-bearing (FB) and mobile-bearing (MB). There is still debate in the literature regarding which of the two is more recommendable, FB UKA or MB UKA. This Editorial presents important data extracted from publications about UKA. The objective is to obtain answers to a still controversial question: which of the two (FB or MB) is more recommendable? To this end, on September 8, 2025, a bibliographic search was conducted in PubMed using the keywords “UKA mobile-bearing versus fixed-bearing.” Fifteen articles were found, of which only thirteen were analyzed because they were directly related to the title of this Editorial. The main conclusion is that orthopedic surgeons should contemplate utilizing cemented FB UKA or uncemented MB UKA due to their better long-run implant survivorship compared with cemented MB UKA. However, this conclusion should be taken with care since the level of evidence is not optimal. Future studies with a high level of evidence will be needed to confirm these conclusions.
Rodriguez-Merchan EC, Gomez-Cardero P. Unicompartmental knee arthroplasty: Current indications, technical issues and results. EFORT Open Rev. 2018;3(6):363-373. doi: 10.1302/2058-5241.3.170048.
Bagherifard A, Jabalameli M, Yahyazadeh H, Ostovar M. Midterm outcomes of unicompartmental knee arthroplasty for the treatment of knee medial compartment osteoarthritis: a retrospective study. Arch Bone Jt Surg. 2023;11(5):326-329. doi: 10.22038/ABJS.2023.66905.3186.
Walsh JM, Burnett RA, Serino J, Gerlinger TL. Painful unicompartmental knee arthroplasty: etiology, diagnosis and management. Arch Bone Jt Surg. 2024;12(8):546-557. doi: 10.22038/ABJS.2024.61787.3030.
Fratini S, Cerasoli T, Meena A, et al. Influence of implant design on failure rates in medial unicompartmental knee arthroplasty: a meta-analysis. J Arthroplasty. 2026;41(1):238-248.e3. doi: 10.1016/j.arth.2025.05.114.
Zhang W, Wang J, Li H, Wang W, George DM, Huang T. Fixed- versus mobile-bearing unicompartmental knee arthroplasty: a meta-analysis. Sci Rep. 2020;10(1):19075. doi: 10.1038/s41598-020-76124-z.
Li MG, Yao F, Joss B, Ioppolo J, Nivbrant B, Wood D. Mobile vs. fixed bearing unicondylar knee arthroplasty: A randomized study on short term clinical outcomes and knee kinematics. Knee. 2006;13(5):365-70. doi: 10.1016/j.knee.2006.05.003.
Migliorini F, Maffulli N, Cuozzo F, et al. Mobile bearing versus fixed bearing for unicompartmental arthroplasty in monocompartmental osteoarthritis of the knee: a meta-analysis. J Clin Med. 2022;11(10):2837. doi: 10.3390/jcm11102837.
Catani F, Benedetti MG, Bianchi L, Marchionni V, Giannini S, Leardini A. Muscle activity around the knee and gait performance in unicompartmental knee arthroplasty patients: a comparative study on fixed- and mobile-bearing designs. Knee Surg Sports Traumatol Arthrosc. 2012;20(6):1042-8. doi: 10.1007/s00167-011-1620-z.
Gu T, Zheng N, Xia C, Zou D, Wang Q, Tsai TY. Mobile-bearing unicompartmental knee arthroplasty enhances patellofemoral function and preserves contralateral knee health versus fixed-bearing. J Orthop Res. 2025;43(10):1757-1766. doi: 10.1002/jor.70017.
Parratte S, Pauly V, Aubaniac JM, Argenson JN. No long-term difference between fixed and mobile medial unicompartmental arthroplasty. Clin Orthop Relat Res. 2012;470(1):61-68. doi: 10.1007/s11999-011-1961-4.
Peersman G, Stuyts B, Vandenlangenbergh T, Cartier P, Fennema P. Fixed- versus mobile-bearing UKA: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2015;23(11):3296-3305. doi: 10.1007/s00167-014-3131-1.
Tay ML, Bolam SM, Maxwell AR, Hooper GJ, Monk AP, Young SW. Similar survivorship but different revision reasons for uncemented mobile-bearing and cemented fixed-bearing medial UKA: a long-term population-based cohort study of 2,015 patients. J Bone Joint Surg Am. 2023;105(10):755-761. doi: 10.2106/JBJS.22.00686.
Fricka KB, Wilson EJ, Strait AV, et al. Outcomes of fixed versus mobile-bearing medial unicompartmental knee arthroplasty. Bone Joint J. 2024;106-B(9):916-923. doi: 10.1302/0301-620X.106B9.BJJ-2024-0075.R1.
RODRIGUEZ-MERCHAN, E. C. (2026). Unicompartmental Knee Arthroplasty: Mobile-bearing or Fixed-bearing?. The Archives of Bone and Joint Surgery, 14(2), 88-89. doi: 10.22038/abjs.2025.91153.4129
MLA
RODRIGUEZ-MERCHAN, E. C. . "Unicompartmental Knee Arthroplasty: Mobile-bearing or Fixed-bearing?", The Archives of Bone and Joint Surgery, 14, 2, 2026, 88-89. doi: 10.22038/abjs.2025.91153.4129
HARVARD
RODRIGUEZ-MERCHAN, E. C. (2026). 'Unicompartmental Knee Arthroplasty: Mobile-bearing or Fixed-bearing?', The Archives of Bone and Joint Surgery, 14(2), pp. 88-89. doi: 10.22038/abjs.2025.91153.4129
CHICAGO
E. C. RODRIGUEZ-MERCHAN, "Unicompartmental Knee Arthroplasty: Mobile-bearing or Fixed-bearing?," The Archives of Bone and Joint Surgery, 14 2 (2026): 88-89, doi: 10.22038/abjs.2025.91153.4129
VANCOUVER
RODRIGUEZ-MERCHAN, E. C. Unicompartmental Knee Arthroplasty: Mobile-bearing or Fixed-bearing?. The Archives of Bone and Joint Surgery, 2026; 14(2): 88-89. doi: 10.22038/abjs.2025.91153.4129