Objective To compare the clinical effects of unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA)for treatment of medial compartment knee osteoarthritis(KOA)in the elderly female patients.Methods The 87 elderly female KOA patients were divided into TKA group(44 cases)and UKA group(43 cases)according to different treatment methods.Surgical duration,intraoperative bleeding loss volume,postoperative drainage volume,the needing time of knee flexing to 90° and length of hospital stay were recorded.Knee joint mobility was measured.Pain visual analogue scale(VAS)and new York Special Surgery Hospital(HSS)score were used to evalu-ate knee pain status and affected limb function,and Oxford Knee Score(OKS)was used to assess the postoperative satisfaction.Results All patients were followed up for 12 months.There was no statistical difference in the surgical duration between the two groups(P>0.05).The volume of intraoperative blood loss,postoperative drainage volume,length of hospital stay and the time required to flex 90° of knee joint in UKA group were less(shorter)than those in TKA group(P<0.05).The HSS scores and pain VAS:at 1,3,and 12 months postoperation,they were better than the preoperation in both groups(P<0.05),and there were all no statistical differences between two groups at various point-time(P>0.05).At the final follow-up,there was no statistical difference in knee flexion range between the two groups(P>0.05);the OKS in the UKA group was higher than that in the TKA group(P<0.01).Conclusions Both UKA and TKA are effective in improving knee joint function in patients with KOA.However,UKA offers the ad-vantages of less surgical trauma and blood loss,shorter hospital stay,better knee joint mobility recovery,and higher pa-tients′satisfaction.