Unicompartmental knee arthroplasty remains a challenge for orthopaedic surgeons because of its higher revision rate compare with the total knee arthroplasty. The hypothesis of this work is that the progression of osteoarthritis in unicompartmental knee prostheses is the natural history of the degenerative disease and a reason for reoperation. Most international joint registries consider this fact as a failure of the implant and a cause of revision. Annual joint registries were searched for progression of osteoarthritis in unicompartmental knee arthroplasty and reasons for their revisions. Current data from registries for unicompartmental knee indicate that the revision rate of such prostheses is overestimated. Considering osteoarthritis progression as the development of the existing disease and not as a failure of the implant, revision rate will be reduced. Registries, reports, and studies are needed to evaluate the progression of osteoarthritis as a cause of reoperation instead of a reason for revision, reducing unicompartmental revision rate and encouraging surgeons to implant more of them.
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