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Unicompartmental arthroplasty of the knee has become an accepted treatment alternative for limited osteoarthritis of the knee. Clinical studies are helping to determine which patients with unicompartmental arthritis of the knee have the most to gain from the limited nature of this surgery. The medium-term clinical results of properly selected patients are comparable to those of total knee arthroplasty. The small components used lend themselves to minimally invasive surgery.The Oxford unicompartmental arthroplasty has been developed to solve the problem of the kinematic conflict in knee arthroplasty design. The two separate articulating surfaces allow for simultaneous high congruency of both articulations while allowing the natural sliding motion in the sagittal plane. Strict attention to surgical technique and patient selection can help to achieve excellent arthroplasty longevity with high patient satisfaction.