Medial unicondylar knee arthroplasty vs total knee. Listing a study does not mean it has been evaluated by the u. Unicondylar knee arthroplasty uka has been promoted for unicompartmental disease of the knee joint. Pdf unicompartmental knee replacement current perspectives. Unicondylar knee replacements have been performed since the early 1970s with mixed success. Unicondylar knee replacement simply means that only a part of the knee joint is replaced through a smaller incision than would normally be used for a total knee replacement. An editorial on outcome of unicondylar knee arthroplasty vs total knee arthroplasty for early medial compartment arthritis.
Material and methods eight consenting patients with seven medial unicondylar and. Revision of unicondylar to total knee arthroplasty. This is in part, because the cruciate ligaments and half of the knee joint are not touched in the surgery. Uka surgery may reduce postoperative pain and have a shorter recovery period than a total knee replacement procedure, particularly in people over 75 years of age. There are a number of factors that determine this including the level of activity that the patient undergoes as well as the possibility of the arthritis extending into the compartments of the knee that were not replaced. Select a tibial trial corresponding to the thickness determined previously. Unicondylar knee arthroplasty orthopaedic foundation. During a unicondylar knee replacement, your doctor will make a small incision in the front of the knee or wherever the damaged area is. The optetrak unicondylar knee system provides for bone preservation through proper ligament tensioning. Unicompartmental knee replacement recon orthobullets. Occasionally mri studies of the knee and even diagnostic arthroscopy to directly visualize the interior of the knee may be necessary to determine if a patient is a candidate for unicompartmental replacement. The drill guide is arranged so as to engage a distal end of the intramedullary rod to that which engages the patients intramedullary canal, and is. This technique can be used to replace some but not all portions of the knee joint if only one area is affected by damage.
Unicondylar knee replacement is technically challenging and malalignment of the implant components is one of the factors that results in high failure rates. The unicondylar knee replacement is ideal for people with. The popularity of unicompartmental knee arthroplasty uka continues to grow, currently accounting for roughly 10% of all knee arthroplasty procedures, and the percentage is anticipated to increase to more than 20% in the future. Unicondylar knee replacement orthopaedic associates of st. She presented with rightsided anteromedial osteoarthritis. This treatment is suitable for people who experience arthritis only in one compartment section of the knee joint, rather than throughout the joint. Kneereplacement surgery is frequently done and highly successful. He did well until recently when he developed persistent right knee pain that is worse with weight bearing. Best unicondylar knee replacement surgeon in nyc ny bone. Unicondylar knee arthroplasty rodriguez hip and knee. Partial knee replacement allows patients to benefit from less scarring, shorter recovery time. We performed a literature search to identify articles reporting on the revision of unicondylar to total knee replacement. The most common indication for the procedure is osteoarthritis. Comparison of open wedge high tibial osteotomy versus.
An editorial on outcome of unicondylar knee arthroplasty. Both total knee arthroplasty tka and unicompartmental knee arthroplasty uka are used to treat unicompartmental knee osteoarthrosis. Unicondylar knee replacement ukr or partial knee arthroplasty tka, is a type of knee replacement involving only the diseased half of the joint. Will a unicondylar knee arthroplasty uka be a viable treatment option if the patellectomized patient has an unicompartmental isolated anteromedial osteoarthritis. There are several types of common knee replacements including bicondylar knee, unicondylar knee, and patellofemoral knee replacements. Traditionally, tka was believed to be a better option due to its durability, inclusive patient selection, and robust longterm data on its effectiveness to reduce pain and restore function. Unicondylar knee replacement for primary osteoarthritis. Unicondylar knee replacements have been performed since the early 1970. System may be porous coated or have embedded mesh to allow a cementless. Severe osteoarthritis median or lateral that results in painful, swollen and stiffened knee. A kit of parts for use in unicondylar knee replacement of a patient having a femur and a tibia comprises a drill guide and an intramedullary rod, the intramedullary rod being sized to fit within the intramedullary canal of the femur of the patient.
Unicompartmental knee arthroplasty uka is a surgical procedure used to relieve arthritis in one of the knee compartments in which the damaged parts of the knee are replaced. The amount of damage is determined through xrays and other imaging. It has the advantages over tibial osteotomy of providing more certain relief of pain, quicker recovery, and better long term survival. This system restores the unique articular surface geometry of the compartment by using an intraoperative 3dimensional mapping system and contoured articular resurfacing implants. Your practice on ine hips knees information on hip, knee. Unicondylar tibiofemoral replacements should be seen as real resurfacings of the knee joint. This procedure is designed to replace only the portions of the knee most damaged by arthritis, leaving the healthier portions intact and letting patients benefit from less.
A total knee arthroplasty performed as a revision unicondylar knee arthroplasty is thought by some authors to have equivalent functional outcomes to a primary total knee replacement. A unicompartmental knee replacement can last anywhere from 5 years to upwards of 15 years. However, there have been several studies suggesting that revision is not as simple as suggested, and that function is not as good as primary total knee arthroplasty. However, patients should be made aware of the lower survival of the ukas compared with total knee arthroplasties. Surgical robotics with navigation is emerging as a potential solution to improve the accuracy of implant placement. In unicompartmental knee replacement also called partial knee replacement only a portion of the knee is resurfaced with metal and plastic components. Zuk is a clinically proven uni knee replacement introduced globally in 2004. Little to no activity restrictions making the arthrosurface implants an active alternative to knee replacement. Unicondylar knee arthroplasty howard rose orthopaedic. Robotically assisted unicompartmental knee arthroplasty. Comparing in vivo kinematics of unicondylar and bi.
Optetrak unicondylar system total knee arthroplasty. Surgical technique sigma hp partial knee depuy synthes 11 figure 16 tibial sizing aim. Also known as a partial knee replacement, a unicondylar knee replacement is an alternative to total knee replacement for patients suffering from osteoarthritis with damage confined to only one compartment of the knee joint. The fit achieved using the precision instrumentation of either the unicap or pf hemicap system is a significant improvement over existing joint replacement products. Download the following assets for more information. Revision rates following unicondylar knee replacement vary among reporting institutions. Partial knee replacement, also known as a unicondylar or unicompartmental knee replacement, is a less invasive form of a total knee replacement. Unicondylar knee arthroplasty uka has been performed for more than three decades. Unicondylar knee replacement orthopaedic associates of. Unicondylar knee arthroplasty intramedullary technique intramedullary guide partial knee replacement femur first technique unicompartmental arthritis arthritis knee kinematics key points use of an intramedullary femoral alignment guide for unicompartmental arthroplasty is a reliable, reproducible technique.
In the 1990s, the high tibial osteotomy hto was the gold standard procedure for treatment of unicompartmental arthritis, particularly in younger patients. The metal pieces are separated by a plastic insert that allows for smooth, fluid. We performed a search using pubmed and ovidmedline and embase using a combination of the search terms unicompartmental, revision knee, unicondylar, knee arthroplasty, and total knee arthroplasty. Pdf longterm results with a lateral unicondylar replacement.
Partial knee replacement also known as unicompartmental knee arthroplasty is a surgical treatment for knee arthritis. Oxford unicompartmental knee manual of the surgical. An editorial on outcome of unicondylar knee arthroplasty vs. Longterm results with a lateral unicondylar replacement article pdf available in clinical orthopaedics and related research 46611. Unicondylar knee replacement princeton new jersey monroe. Unicondylar knee arthroplasty, also known as partial or unicompartmental knee replacement, is a less invasive alternative to a total knee arthroplasty. Unicompartmental arthroplasty uka is a partial knee replacement, it resurfaces either the medial 90% or lateral10% compartment. Place the knee in extension and assess the extension gap with the tibial trial figure 18.
Medial unicondylar knee arthroplasty vs total knee arthroplasty ukavstka the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Unicondylar knee arthroplasty following a patellectomy. Because replacement is increasingly considered for patients younger than 55 years, improved decision. The woman in this case showed excellent postoperative clinical results.
Resultant femoral and tibial implant placement was compared to the planned implant position. Mckeever in the 1950s, followed up by both mckeever and macintosh introducing metallic tibial components that. Maximize tibial cortical coverage with no overhang. The suggested benefits of uka over total knee replacement are a shorter rehabilitation time, a greater average range of motion, and preservation of the proprioceptive function of knee ligaments with a more naturalfeeling knee. Outcome of unicondylar knee arthroplasty vs total knee. Unicondylar knee arthroplasty in patellectomized patients. It wasnt long ago that knee replacement surgery was reserved for the elderly. The postoperative functional outcome was good to excellent in all reports except one, which described revision surgery of all three patients. Adverse outcomes after total and unicompartmental knee. The accuracy of performing unicondylar knee replacement using a freehand sculpting, semi. This is a less invasive procedure that allows for a more natural feel after surgery. Unicondylar knee arthroplasty orthopedic medical center.
Download procedure basics pdf on knee replacements curvo labs. Knee replacement surgery is frequently done and highly successful. Robotically assisted unicompartmental knee arthroplasty with. In cases of osteoarthritis, unicompartmental knee replacement competes with upper tibial osteotomy at one end of the disease spectrum and with total condylar joint replacement at the other. Unicondylar knee replacement mahwah osteoarthritis fair. Shalby hospitals multi specialty hospital 73,089 views. Us patent for unicondylar knee replacement patent patent. It should, in theory, also restore the normal kinematics of the knee. In the literature, we found only a few similar cases, with varying results. Assess cortical bone coverage when placed on the tibia.
Author links open overlay panel vikas kulshrestha ms. In conclusion, this study shows that open wedge high tibial osteotomy and unicondylar knee replacements have no significant. Partial knee arthroplasty is designed to replace only the portion of the knee that has been damaged by arthritis, leaving the healthier areas intact. Accuracy of a freehand sculpting tool for unicondylar knee. Small pieces of bone are then removed from the damaged area of the femur and tibia, and are then replaced by metal prosthetics. Unicompartmental knee replacement page 7 subacromial decompression oxford unicompartmental knee replacement depending on how much of your knee is affected by arthritis, surgeons can sometimes perform a partial knee replacement also known as a unicompartmental knee replacement, ukr as opposed to a total knee replacement tkr. The extension gap can be filled 1, 2 or 3 mm distally with use of a femoral defect shim. We present a case of a 59yearold woman with a history of a rightsided patellectomy. An unicondylar replacement cannot change the original natural alignment or ligament balance of the knee. Unicompartmental knee replacement ukr is an effective treatment for endstage, symptomatic unicompartmental osteoarthritis of the knee. There is paucity of literature on unicondylar knee arthroplasty in postpatellectomy patients with isolated anteromedial knee arthritis. Unicondylar knee arthroplasty intramedullary technique intramedullary guide partial knee replacement femur first technique unicompartmental arthritis arthritis knee kinematics key points use of an intramedullary femoral alignment guide for unicompartmental arthroplasty is a. Knee replacements are performed more often than hip replacements in the us.
Outcome of unicondylar knee arthroplasty vs total knee arthroplasty for early medial compartment arthritis. It relieves pain and improves knee function in people with advanced arthritis of the joint. Will the little increase in anteroposterior instability be a contraindication for the placement of an uka. Oxford unicompartmental knee manual of the surgical technique. When the cause for revision of knee replacement was studied from the new zealand joint registry data, it was noted that the early revision rate for the oxford unicompartmental knee was 2. Total knee replacement, however, remains the treatment of choice in a severely arthritic knee where all the joint compartments are damaged. Vikram shah at shalby hospitals using zero technique. The unicondylar knee replacement uka centre had 22 patients over june 2012 to august 20 and used the oxford partial knee system in these operations. Its biomedicallyinspired articular geometry and proprietary net compression molded polyethylene facilitate restoration for preprimary total knee replacement.
1484 1202 1268 277 1074 1264 1239 1160 510 1106 570 999 1425 1239 965 722 1281 1493 993 1169 506 325 80 843 282 1513 678 1577 305 176 43 636 585 820 922 732 786 1389 39 1289 1145 253