Replacement of the patellofemoral and medial tibiofemoral joints has been performed since the 1980s. Bicompartmental replacement was modified. Two different designs were developed: one custom implant and one with multiple predetermined sizes. The surgical technique and instruments are unique and training is helpful. There are no clinical reports for the custom design as of yet. The standard implant has several reports in the literature with only fair to good results and has subsequently been withdrawn from the market. Bicompartmental arthroplasty remains a questionable area of knee surgery. At present, the two separate implant technique is the best choice.
Bicompartmental arthroplasty is a bone-preserving procedure that also preserves both of the cruciate ligaments.
The two separate implant technique allows the surgeon to concentrate on one area and then the other without compromising either arthroplasty.
Presently, bicompartmental arthroplasty does not have acceptable long-term results. However, there may still be a place for the procedure with custom-made implants that are positioned more accurately either with navigation control or patient-specific cutting blocks.