Beard DJ, et al. - Through a multicentre, pragmatic randomized controlled trial conducted at 27 UK sites, the researchers evaluated the clinical effectiveness and cost-effectiveness of total knee replacement (TKR) vs partial knee replacement (PKR) in subjects with medial compartment osteoarthritis of the knee, and represented an assessment of the main endpoints at 5 years. A total of 528 participants were randomly allotted to groups. Nearly 94% of subjects answered the follow-up survey 5 years following their operation. No variation in Oxford Knee Score among groups was discovered at the 5-year follow-up. In this within-trial cost-effectiveness analysis, PKR was observed to be more efficient and less costly in comparison with TKR during the 5 years of follow-up. This conclusion was an outcome of slightly better results, lower costs of surgery and lower follow-up health-care costs with PKR as that of TKR. Hence, both TKR and PKR were concluded to be efficient, offered similar clinical outcomes, and led to a similar incidence of re-operations and complications. Moreover, PKR should be acknowledged as the first choice for cases with late-stage isolated medial compartment osteoarthritis, on the basis of clinical findings, and results concerning the lower costs and better cost-effectiveness with PKR during the 5-year study period.