The study compared two surgical methods for the treatment of lateral knee osteoarthritis with anterior knee pain: lateral unicompartmental arthroplasty (LUCA) and total knee arthroplasty (TKA). 115 patients (52 with LUKA and 63 with TKA) were included in the research and were followed for 24 months. LUKA was associated with shorter operative time, less blood loss, and shorter hospital stay, showing better early outcomes and lower lateral knee pain at 3 months. However, at 24 months, there were no statistically significant differences between the two groups in total knee function score (KSS), WOMAC score, or pain distribution. There were no revisions after LUKE, while there was one infection treated conservatively after TKA. The study concluded that LUKA allowed for a faster early recovery with less surgical burden, but long-term results were comparable to TKA.