Author links open overlay panel vikas kulshrestha ms. Knee replacements are performed more often than hip replacements in the us. Unicondylar knee replacements have been performed since the early 1970s with mixed success. Surgical robotics with navigation is emerging as a potential solution to improve the accuracy of implant placement. Unicondylar knee arthroplasty rodriguez hip and knee.
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. 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. Revision of unicondylar to total knee arthroplasty. An editorial on outcome of unicondylar knee arthroplasty vs total knee arthroplasty for early medial compartment arthritis. 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. Severe osteoarthritis median or lateral that results in painful, swollen and stiffened knee. 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. Unicondylar knee replacement mahwah osteoarthritis fair. Place the knee in extension and assess the extension gap with the tibial trial figure 18. Surgical technique sigma hp partial knee depuy synthes 11 figure 16 tibial sizing aim.
This treatment is suitable for people who experience arthritis only in one compartment section of the knee joint, rather than throughout the joint. We performed a literature search to identify articles reporting on the revision of unicondylar to total knee replacement. Listing a study does not mean it has been evaluated by the u. Unicondylar knee arthroplasty orthopaedic foundation. Unicondylar knee replacement orthopaedic associates of st. Robotically assisted unicompartmental knee arthroplasty. Your practice on ine hips knees information on hip, knee. 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. The metal pieces are separated by a plastic insert that allows for smooth, fluid. Pdf longterm results with a lateral unicondylar replacement. Resultant femoral and tibial implant placement was compared to the planned implant position. Knee replacement surgery is frequently done and highly successful.
This technique can be used to replace some but not all portions of the knee joint if only one area is affected by damage. Comparison of open wedge high tibial osteotomy versus. Download the following assets for more information. 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. However, patients should be made aware of the lower survival of the ukas compared with total knee arthroplasties. This system restores the unique articular surface geometry of the compartment by using an intraoperative 3dimensional mapping system and contoured articular resurfacing implants.
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. 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. There are several types of common knee replacements including bicondylar knee, unicondylar knee, and patellofemoral knee replacements. Zuk is a clinically proven uni knee replacement introduced globally in 2004. The accuracy of performing unicondylar knee replacement using a freehand sculpting, semi. Vikram shah at shalby hospitals using zero technique. Kneereplacement surgery is frequently done and highly successful. Pdf unicompartmental knee replacement current perspectives. 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.
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. It should, in theory, also restore the normal kinematics of the knee. She presented with rightsided anteromedial osteoarthritis. Outcome of unicondylar knee arthroplasty vs total knee. 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. Longterm results with a lateral unicondylar replacement article pdf available in clinical orthopaedics and related research 46611. Unicondylar knee replacement for primary osteoarthritis. Will a unicondylar knee arthroplasty uka be a viable treatment option if the patellectomized patient has an unicompartmental isolated anteromedial osteoarthritis. Jan 27, 2015 present status of unicondylar knee arthroplasty 1.
Revision rates following unicondylar knee replacement vary among reporting institutions. Total knee replacement, however, remains the treatment of choice in a severely arthritic knee where all the joint compartments are damaged. Oxford unicompartmental knee manual of the surgical. Unicompartmental arthroplasty uka is a partial knee replacement, it resurfaces either the medial 90% or lateral10% compartment. The woman in this case showed excellent postoperative clinical results. Material and methods eight consenting patients with seven medial unicondylar and. Unicondylar knee arthroplasty following a patellectomy.
Minimally invasive unicondylar knee resurfacing is not a minor procedure but can be done as a short stay procedure in hospital and is associated with faster recovery and rehabilitation time with a lower. Knee solutions unicompartmental knee arthroplasty system. The unicondylar knee replacement is ideal for people with. Us patent for unicondylar knee replacement patent patent. 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. 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. Partial knee replacement, also known as a unicondylar or unicompartmental knee replacement, is a less invasive form of a total knee replacement. Unicondylar knee replacement is technically challenging and malalignment of the implant components is one of the factors that results in high failure rates. Robotically assisted unicompartmental knee arthroplasty with. Unicondylar knee replacement princeton new jersey monroe.
He did well until recently when he developed persistent right knee pain that is worse with weight bearing. Its biomedicallyinspired articular geometry and proprietary net compression molded polyethylene facilitate restoration for preprimary total knee replacement. Small pieces of bone are then removed from the damaged area of the femur and tibia, and are then replaced by metal prosthetics. 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. In the 1990s, the high tibial osteotomy hto was the gold standard procedure for treatment of unicompartmental arthritis, particularly in younger patients. Unicompartmental knee replacement ukr is an effective treatment for endstage, symptomatic unicompartmental osteoarthritis of the knee. Unicompartmental knee replacement recon orthobullets. Optetrak unicondylar system total knee arthroplasty. 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. Mckeever in the 1950s, followed up by both mckeever and macintosh introducing metallic tibial components that. Outcome of unicondylar knee arthroplasty vs total knee arthroplasty for early medial compartment arthritis. Unicondylar knee arthroplasty, also known as partial or unicompartmental knee replacement, is a less invasive alternative to a total knee arthroplasty. It relieves pain and improves knee function in people with advanced arthritis of the joint.
Little to no activity restrictions making the arthrosurface implants an active alternative to knee replacement. Maximize tibial cortical coverage with no overhang. The extension gap can be filled 1, 2 or 3 mm distally with use of a femoral defect shim. Medial unicondylar knee arthroplasty vs total knee. Oxford unicompartmental knee manual of the surgical technique. Download procedure basics pdf on knee replacements curvo labs. 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. Accuracy of a freehand sculpting tool for unicondylar knee. It has the advantages over tibial osteotomy of providing more certain relief of pain, quicker recovery, and better long term survival. A unicompartmental knee replacement can last anywhere from 5 years to upwards of 15 years. The most common indication for the procedure is osteoarthritis.
There is paucity of literature on unicondylar knee arthroplasty in postpatellectomy patients with isolated anteromedial knee arthritis. 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. Assess cortical bone coverage when placed on the tibia. Select a tibial trial corresponding to the thickness determined previously. Unicondylar tibiofemoral replacements should be seen as real resurfacings of the knee joint. An editorial on outcome of unicondylar knee arthroplasty. 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. Unicondylar knee arthroplasty uka has been promoted for unicompartmental disease of the knee joint. The amount of damage is determined through xrays and other imaging. 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 unicondylar knee replacement uka centre had 22 patients over june 2012 to august 20 and used the oxford partial knee system in these operations. 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. 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. 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. Comparing in vivo kinematics of unicondylar and bi. In unicompartmental knee replacement also called partial knee replacement only a portion of the knee is resurfaced with metal and plastic components. Partial knee replacement also known as unicompartmental knee arthroplasty is a surgical treatment for knee arthritis. Partial knee replacement allows patients to benefit from less scarring, shorter recovery time.
An editorial on outcome of unicondylar knee arthroplasty vs. Because replacement is increasingly considered for patients younger than 55 years, improved decision. Both total knee arthroplasty tka and unicompartmental knee arthroplasty uka are used to treat unicompartmental knee osteoarthrosis. This procedure is an alternative to total knee replacement for patients whose disease is limited to just one area of the knee. This is a less invasive procedure that allows for a more natural feel after surgery. Shalby hospitals multi specialty hospital 73,089 views. We searched medline, embase, and the cochrane library on july 31, 20, to retrieve all studies comparing unicompartmental knee replacement ukr and total knee replacement tkr in terms of revision rate, mortality, or complications. Unicondylar knee arthroplasty uka has been performed for more than three decades. Best unicondylar knee replacement surgeon in nyc ny bone.
Unicondylar knee arthroplasty in patellectomized patients. Will the little increase in anteroposterior instability be a contraindication for the placement of an uka. Adverse outcomes after total and unicompartmental knee. System may be porous coated or have embedded mesh to allow a cementless.
Unicondylar knee replacements have been performed since the early 1970. In the literature, we found only a few similar cases, with varying results. Unicondylar knee replacement orthopaedic associates of. Unicondylar knee replacement ukr or partial knee arthroplasty tka, is a type of knee replacement involving only the diseased half of the joint. Unicondylar knee replacement also known as unicompartmental knee replacement, unicondylar knee replacement is a less invasive alternative to a total knee replacement. We present a case of a 59yearold woman with a history of a rightsided patellectomy. Unicondylar knee arthroplasty howard rose orthopaedic. Unicondylar knee arthroplasty orthopedic medical center. This is in part, because the cruciate ligaments and half of the knee joint are not touched in the surgery. In conclusion, this study shows that open wedge high tibial osteotomy and unicondylar knee replacements have no significant. 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. The optetrak unicondylar knee system provides for bone preservation through proper ligament tensioning. An unicondylar replacement cannot change the original natural alignment or ligament balance of the knee.