In the past, treatment of knee osteoarthritis has been limited to unicompartmental knee replacement or total knee arthroplasty (TKA). Neither option is well suited for the active patient with midstage osteoarthritis of the medial and patellofemoral compartments. Now an alternative treatment is available that targets the diseased area without sacrifice of normal bone or both the cruciate ligaments. Minimally invasive surgical techniques are easily used, which reduces tissue trauma and results in a quicker recovery than TKA. Bicompartmental replacement offers decreased pain, stability through normal ligament structure, and the retention of normal bone for patients with medial and patellofemoral osteoarthritis.