Forty-nine patients (52 knees) with anterior medial knee osteoarthritis were randomized to undergo MB-UKA with either the traditional “two-finger” method (n=26) or the measured resection method (n=26) for gap balance. The primary outcome was range of motion (ROM). Secondary outcomes included pain relief measured by VAS, functional improvement assessed by Oxford knee score (OKS), Global Perceived Scale (GPE), and prosthetic angles. Outcomes were evaluated at baseline and 6-month follow-up. Overall, the results of the study revealed that the measured resection method provided significantly better ROM, VAS, and OKS at 6 months, without significant differences in prosthetic angles or GPE. The findings suggest that the measured resection method can offer improved clinical outcomes by providing a more quantifiable and reproducible approach to gap balancing in MB-UKA.