Influence of minimally invasive surgery on implant positioning and the functional outcome for medial unicompartmental knee arthroplasty (original) (raw)
Related papers
The Journal of arthroplasty, 2003
This is a retrospective radiographic analysis of implant position in minimally invasive unicompartmental knee arthroplasty (UKA), open UKA, and total knee arthroplasty (TKA). Implant position and limb alignment were recorded in the AP and lateral planes. Of the 3 groups evaluated, the total knee group had the least variation and greatest accuracy of implant placement and limb alignment. UKA groups had small but significant differences in postoperative alignment and AP tibial position. Using contemporary instrumentation, UKA is less accurate than TKA in implant placement and limb alignment. Minimally invasive UKA was not as accurate as open UKA in AP tibial placement or postoperative limb alignment.
Clinics in Orthopedic Surgery, 2015
The results of unicompartmental knee arthroplasty (UKA) are unsatisfactory at the initial period of implementation owing to the inferior prosthetic design, suboptimal surgical technique, and poor patient selection. However, numerous outstanding results with the improvements in the functions of the knee joint and the survival rate of implants have been reported recently through accurate selection criteria, ongoing improvements in the prosthetic design and surgical technique. 1-3) Although majority of reports have satisfactory results on the functions of knee joint after the UKA at the moment, diverse range of results are being reported on the survivorship of UKA depending on the indications, types of implants and surgeons, therefore leaving substantial controversy in long-term results of UKA. 4-6) In particular, minimally invasive UKA, as one of the key factors that improved the clinical results and increased the usage of UKA since its first introduction in the latter part of the 1990's, has been reported to produce satisfactory alignment of implants and outstanding
The Journal of Arthroplasty, 2013
Accurate implant positioning and restoration of lower limb alignment are major requirements for successful long-term results in unicompartmental knee arthroplasty (UKA). Alignment accuracy was compared between navigated-UKA (nUKA) and conventional-UKA (cUKA) groups using a retrospective matched case-control study (n=129, 58 nUKA, 71 cUKA). Mechanical axis (MA), hip-knee-ankle angle (HKA°), coronal implant alignment, and tibial implant posterior slope were measured. No statistically significant difference was observed when comparing MA, HKA°or coronal implant alignment (pN0.05). Statistical significance was seen with tibial component posterior slope (p=0.04, nUKA 4.2°, cUKA 2.9°); and between intra-operative navigationally determined HKA°and post-operative whole-leg standing (WLS) film HKA°. Navigation does not significantly improve UKA alignment compared to conventional methods. Further studies are needed to justify the use of this technology in UKA.
Knee Surgery, Sports Traumatology, Arthroscopy, 2011
Purpose In the last decade, a major increase in the use of and interest in unicompartmental knee arthroplasty (UKA) has developed. The Oxford Phase 3 UKA is implanted with a minimally invasive technique using newly developed instruments. The objective of this prospective study was to evaluate the outcome of UKA in patients with medial osteoarthritis of the knee in a high-volume unit. Methods Two-hundred and forty-four UKAs were performed with a minimally invasive approach. The median age was 72 (43-91) years. The median follow-up was 4.2 years (range 1-10.4 years). Fourteen patients died, and nine were considered to be lost to follow-up, but all had a well-functioning prosthesis in situ until their last follow-up. Pain, function and health-related quality of life were evaluated pre-and postoperatively using patient-and assessor-based outcome scores, as well as radiographic evidence.
Unicompartimental Knee Arthroplasty - 15 Years Follow Up
Acta Ortopédica Brasileira
Objective: To evaluate clinically and radiologically the long-term follow-up of patients with anteromedial osteoarthritis who underwent unicompartmental knee arthroplasty surgery. Methods: This study included 36 patients who underwent unicompartmental knee arthroplasty surgery for medial compartmental osteoarthritis with a minimum of 15-year post-operative follow-up. All surgeries were performed by a single surgeon (G.L.C) using the Miller-Galante unicompartmental knee implant. Patients were analyzed regarding their clinical functional and implant radiographic conditions. Results: From the 46 patients who could have completed 15 years of follow-up, three required revision surgery with conversion to total knee arthroplasty (6.5%), 36 completed the 15-year follow-up period, and the others were lost to follow-up for reasons not related to unicompartmental arthroplasty. Conclusion: In these 36 patients, the result was satisfactory after follow-up, with complaints and sign of progression...
Advances in unicompartmental knee arthroplasty with minimally invasive techniques
Journal of Orthopaedics and Traumatology, 2006
Unicompartmental arthroplasty has proved to be a reliable option for monocompartmental arthritis in well selected patients. Unicompartmental knee arthroplasty (UKA) is not a temporary procedure and its ten year survival is comparable to TKA and better than High Tibial Osteotomy. The success of the procedure depends on strict patient selection, meticulous surgical technique and proper implant selection. The renewed interest in UKA is due to improved results, more conservative nature of the procedure, faster rehabilitation, decreased cost and the minimally invasive techniques. The sedentary patient with unicompartmental arthritis is currently the primary indication for UKA. The role of unicompartmental arthroplasty in younger patients needs more investigation. Revision of UKA has not found to be as complicated as reported in the early series. Minimally invasive UKA has shown short term promising results but more long term studies showing similar implant longevity compared with the standard approach are required to establish its role. Due to high level of patient satisfaction and low morbidity and complications compared with TKA, unicompartmental arthroplasty is an attractive option for patients with predominantly unicompartmental non inflammatory arthritis.
Ortopedia, traumatologia, rehabilitacja
Background. Since the introduction minimally invasive techniques, interest in unicompartmental knee arthroplasty (UKA) has rapidly increased. This minimally invasive approach preserves the anatomy of the knee with less damage to extensor mechanisms, less morbidity, and quicker post-operative recovery. The purpose of our study was to evaluate this new treatment option for anteromedial osteoarthritis, both clinically and radiographically, and to identify any possible drawbacks. Material and methods. Between January 1999 and August 2003 88 consecutive Oxford Phase 3 UKAs were implanted by a single surgeon. All patients with a minimal follow-up (FU) period of 2 years were pre- and post- operatively clinically evaluated by the American Knee Society (AKS) Score and radiographically according to the Oxford Centre criteria, including fluoroscopy. Results. Twenty-eight patients with 30 prostheses with a minimal follow-up period 2 years (2.54 +/- 0.48 yrs) were included in this study. The AKS...
Journal of Arthroplasty, 2010
The aim of this study was to evaluate the intermediate-term survivorship of cemented fixed-bearing unicompartmental knee arthroplasty (UKA). One hundred twenty-eight consecutive UKAs in 98 patients were performed by a single surgeon with "Allegretto" UKA prostheses. Six patients died and 5 were lost to follow-up, leaving 87 patients (116 knees) with an average followup of 5.7 years (range, 3-8 years). At the latest follow-up, the survival rate was 92.2%; average clinical and functional knee society scores improved from 50 and 64 points preoperatively to 89 and 88 points, respectively; and average total knee score was 171 (range, 94-200). Radiographic follow-up demonstrated average alignment of 3°valgus (range, 6°varus to 7°valgus). Ninety-two percent of the patients indicated satisfaction with the procedure. Nine knees failed requiring revision at an average of 40.4 months. We are encouraged with the satisfactory results, considering the broader spectrum of selected patients.
The Oxford unicompartmental knee prosthesis: a 2?14�year follow-up
Knee Surgery, Sports Traumatology, Arthroscopy, 2005
Osteoarthritis (OA) of the knee is a very common problem. In 80-90% of cases it begins in the medial compartment, and tends to remain unicompartmental . The Oxford unicompartmental knee prosthesis (OUKP) consists of a spherical femoral and a flat tibial component, with a closely-fitting but unconstrained meniscal bearing in between. This design allows rotation and translation, whilst providing large contact areas. Theoretically this results in less transmission of the associated forces and couples, and in less polyethylene wear . Over the past 20 years, the overall results of unicompartmental knee prostheses, specifically of the Oxford type, have been very promising .
Clinical orthopaedics and related research, 2015
Component alignment can influence implant longevity as well as perhaps pain and function after unicompartmental knee arthroplasty (UKA), but correct alignment is not consistently achieved. To increase the likelihood that good alignment will be achieved during surgery, smart tools such as robotics or patient-specific instrumentation (PSI) have been introduced. We hypothesized that UKA performed with PSI would result in improved level gait as ascertained with three-dimensional analysis, implant positioning, and patient-reported outcomes measured by a validated scoring system when compared with conventional instrumentation 3 months and 1 year after surgery. We randomized 60 patients into two groups using either the PSI technique or a conventional technique. All patients were operated on using the same technique and the same cemented metal-backed implant. Mean age of the patients was 63 ± 4 years (range, 54-72 years) and mean body mass index was 28 ± 3 kg/m(2). Patients were evaluated p...