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Unicompartmental knee

Julio J Jauregui, Christopher L Blum, Neil Sardesai, Craig Bennett, R Frank Henn, Farshad Adib
BACKGROUND: Spontaneous osteonecrosis of the knee (SONK) is a poorly understood but debilitating disease entity. Total knee arthroplasty (TKA) is the standard of care for those patients who fail conservative management, but considering SONK's predilection for affecting a single knee compartment, unicompartmental knee arthroplasty (UKA) appears to be a more tailored option. Unfortunately, conflicting data exist on the utility of UKA in SONK. Thus, the purpose of this study was to evaluate functional outcomes and revision rates of UKA in the setting of SONK...
May 2018: Journal of Orthopaedic Surgery
Yuichi Kuroda, Koji Takayama, Kazunari Ishida, Shinya Hayashi, Shingo Hashimoto, Masanori Tsubosaka, Takehiko Matsushita, Takahiro Niikura, Kotaro Nishida, Ryosuke Kuroda, Tomoyuki Matsumoto
PURPOSE: This study aimed to determine the correlation between the change in joint line height calculated from the resected bone and insert thickness during surgery and the change in limb alignment following unicompartmental knee arthroplasty (UKA). It was hypothesized that joint line elevation is correlated with the change in limb alignment. METHODS: A total of 74 consecutive patients diagnosed with either isolated medial compartmental osteoarthritis (38 patients) or spontaneous osteonecrosis of the knee (36 patients) were included...
April 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Charles Rivière, Stefan Lazic, Oliver Boughton, Yann Wiart, Loic Vïllet, Justin Cobb
Mechanical or anatomical alignment techniques create a supposedly 'biomechanically friendly' but often functionally limited prosthetic knee.Alternative techniques for alignment in total knee arthroplasty (TKA) aim at being more anatomical and patient-specific, aiming to improve functional outcomes after TKA.The kinematic alignment (KA) technique for TKA has shown good early clinical outcomes. Its role in extreme anatomical variation remains to be defined.The restricted KA technique for TKA might be a reasonable option for patients with extreme anatomical variation...
January 2018: EFORT Open Reviews
Tobias Reiner, Martin Schwarze, Benjamin Panzram, Matthias C Klotz, Rudi G Bitsch, Sebastian Jaeger
BACKGROUND: The twin peg femoral component was introduced for the cemented Oxford unicondylar knee to increase implant stability. The aim of this experimental study was to investigate the influence of the twin peg design on femoral interface temperature and maximum load to failure in comparison to the single peg design. METHODS: In this experimental study medial Oxford unicompartmental knee arthroplasty was performed in 12 pairs of fresh-frozen human knees. A cemented femoral single peg component was implanted on the one side (group A) and a cemented twin peg component on the other side (group B)...
April 5, 2018: Clinical Biomechanics
B P Chalmers, K G Mehrotra, R J Sierra, M W Pagnano, M J Taunton, M P Abdel
Aims Primary (or spontaneous) and secondary osteonecrosis of the knee can lead to severe joint degeneration, for which either total or unicompartmental arthroplasty may be considered. However, there are limited studies analyzing outcomes of unicompartmental knee arthroplasties (UKAs) for osteonecrosis involving an isolated compartment of the knee. The aims of this study were to analyze outcomes of UKAs for osteonecrosis with specific focus on 1) survivorship free of any revision or reoperation, 2) risk factors for failure, 3) clinical outcomes, and 4) complications...
April 1, 2018: Bone & Joint Journal
D W Murray, R W Parkinson
Unicompartmental knee arthroplasty (UKA) has numerous advantages over total knee arthroplasty (TKA) and one disadvantage, the higher revision rate. The best way to minimize the revision rate is for surgeons to use UKA for at least 20% of their knee arthroplasties. To achieve this, they need to learn and apply the appropriate indications and techniques. This would decrease the revision rate and increase the number of UKAs which were implanted, which would save money and patients would benefit from improved outcomes over their lifetime...
April 1, 2018: Bone & Joint Journal
Stefano Campi, Saket Tibrewal, Rory Cuthbert, Sheo B Tibrewal
Unicompartmental knee replacement (UKR) is an effective treatment for end-stage, symptomatic unicompartmental osteoarthritis of the knee. However, certain aspects of the procedure are still debated. These areas of discussion include patient selection criteria, implant design and the discrepancy in survival rates between national registries and independent case series. These may contribute in limiting the more widespread acceptance of unicompartmental knee replacement. The aim of this paper is to review the up-to-date evidence on UKR and discuss the most relevant controversies regarding this procedure...
January 2018: Journal of Clinical Orthopaedics and Trauma
Alisdair Gilmour, Angus D MacLean, Philip J Rowe, Matthew S Banger, Iona Donnelly, Bryn G Jones, Mark J G Blyth
BACKGROUND: Unicompartmental knee arthroplasty (UKA) for treatment of medial compartment osteoarthritis has potential benefits over total knee arthroplasty but UKA has a higher revision rate. Robotic-assisted UKA is increasingly common and offers more accurate implant positioning and limb alignment, lower early postoperative pain but evidence of functional outcome is lacking. The aim was to assess the clinical outcomes of a single-centre, prospective, randomised controlled trial, comparing robotic-arm-assisted UKA with conventional surgery...
February 21, 2018: Journal of Arthroplasty
Graham Seow-Hng Goh, Ming Han Lincoln Liow, Hee-Nee Pang, Darren Keng-Jin Tay, Ngai-Nung Lo, Seng-Jin Yeo
BACKGROUND: The relationship between mental health and outcomes of unicompartmental knee arthroplasty (UKA) remains unclear. Poor preoperative mental health may be caused by pain and functional limitations associated with knee arthritis. We aimed at (1) investigating the effect of preoperative mental health on early outcomes and (2) assessing whether mental health improves after UKA. METHODS: Prospectively collected registry data of 1473 medial UKAs performed at a single institution in 2007-2014 were reviewed...
February 26, 2018: Journal of Arthroplasty
C Siedlecki, P Beaufils, B Lemaire, N Pujol
BACKGROUND: Single-stage bilateral knee arthroplasty, even when unicompartmental, remains controversial, chiefly due to the risk of peri-operative complications. The primary objective of this study was to compare the short-term complication rate and cost of single- vs. two-stage bilateral unicompartmental knee arthroplasty (UCA). The secondary objective was to compare total hospital stay lengths and motion-range recovery. HYPOTHESIS: Single-stage bilateral UCA is a cost-saving alternative that is not associated with higher complication rates compared to two-stage bilateral UCA...
April 4, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Hyuck Min Kwon, Ick-Hwan Yang, Woo-Suk Lee, Alvin Ray L Yu, Sang Yun Oh, Kwan Kyu Park
Accurate measurement of knee range of motion (ROM) is critical to predict the outcomes of knee surgery and prognosis. We investigated the reliability of knee ROM measurements by goniometer compared with robotic system. Fifty-three patients with medial osteoarthritis who were planning to undergo unicompartmental knee arthroplasty (UKA) with robotic UKA were prospectively enrolled. During the operation, knee ROM measurement was performed in both flexion and extension before and after insertion of the implant using both a goniometer and robotic system...
April 4, 2018: Journal of Knee Surgery
Alexander H Jinnah, Marco A Augart, Daniel L Lara, Riyaz H Jinnah, Gary G Poehling, Chukwuweike U Gwam, Johannes F Plate
INTRODUCTION: Unicompartmental knee arthroplasty (UKA) is a commonly used procedure for patients suffering from debilitating unicompartmental knee arthritis. For UKA recipients, robotic-assisted surgery has served as an aid in improving surgical accuracy and precision. While studies exist detailing outcomes of robotic UKA, to our knowledge, there are no studies assessing time to return to work using robotic-assisted UKA. Thus, the purpose of this study was to prospectively assess the time to return to work and to achieve the level of work activity following robotic-assisted UKA to create recommendations for patients preoperatively...
March 29, 2018: Surgical Technology International
Qais Naziri, Patrick J Mixa, Daniel P Murray, Roby Abraham, Bashir A Zikria, Akhilesh Sastry, Preetesh D Patel
INTRODUCTION: Unicompartmental knee arthroplasty (UKA) effectively improves pain and function associated with isolated compartmental knee arthritis. The developments of computer-navigated and robotic-assisted UKA are among the most significant changes that have improved patient outcomes. This study aimed to systematically review the literature to identify differences between computer-navigated and robotic-assisted UKAs. MATERIALS AND METHODS: Twenty total articles were identified...
March 29, 2018: Surgical Technology International
Stefano Campi, Hemant G Pandit, Christiaan R Oosthuizen
BACKGROUND: The Oxford unicompartmental knee arthroplasty (OUKA) is a successful treatment for endstage, symptomatic anteromedial osteoarthritis. This study reports the results of a cohort of consecutive cemented and cementless medial OUKAs from an independent center and aims to answer the following questions: what is the survival of OUKA in the hands of a nondesigner surgeon? Are there any differences in the survival of cementless and cemented OUKA? Are the failure modes any different with the cementless and cemented OUKA? METHODS: One thousand one hundred twenty consecutive OUKAs were implanted in a single center for the recommended indications...
February 2, 2018: Journal of Arthroplasty
Michael D Ries
No abstract text is available yet for this article.
March 28, 2018: Clinical Orthopaedics and related Research
Jonathan R Danoff, Rahul Goel, R Andrew Henderson, James Fraser, Peter F Sharkey
BACKGROUND: This study compares the effectiveness of 2 commonly used periarticular injection formulations: liposomal bupivacaine and bupivacaine (EXP) and ropivacaine, epinephrine, ketorolac, and clonidine (ROP) in patients undergoing bilateral total knee arthroplasty or unicompartmental knee arthroplasty. METHODS: Twenty-six total knee arthroplasty patients (52 knees) and 3 unicompartmental knee arthroplasty patients (6 knees) undergoing simultaneous, bilateral arthroplasty were randomized to receive periarticular injections in a blinded fashion...
March 6, 2018: Journal of Arthroplasty
J D Parker, K S Lim, D C Kieser, T B F Woodfield, G J Hooper
Aims The intra-articular administration of tranexamic acid (TXA) has been shown to be effective in reducing blood loss in unicompartmental knee arthroplasty and anterior cruciate reconstruction. The effects on human articular cartilage, however, remains unknown. Our aim, in this study, was to investigate any detrimental effect of TXA on chondrocytes, and to establish if there was a safe dose for its use in clinical practice. The hypothesis was that TXA would cause a dose-dependent damage to human articular cartilage...
March 1, 2018: Bone & Joint Journal
Jin Kyu Lee, Hyun Jung Kim, Jae Ok Park, Jae-Hyuk Yang
PURPOSE: The purpose of this study was to compare the revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) with primary TKA through a review of previously published studies. The hypothesis was that the revised UKA group would need additional operative procedures, including the use of stems and augments, resulting in poorer clinical outcomes than those of the primary TKA group. METHODS: A literature search of online register databases was performed to identify clinical trials that compared revised UKA to TKA with primary TKA...
March 27, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Keizo Wada, Daisuke Hamada, Tomoya Takasago, Akihiro Nitta, Tomohiro Goto, Ichiro Tonogai, Yoshihiro Tsuruo, Koichi Sairyo
PURPOSE: The aim of this study was to compare the intraoperative kinematics of medial and lateral unicompartmental knee arthroplasty (UKA) with those of the native knee using a navigation system. METHODS: Six fresh-frozen cadaveric knees were included in the study. Medial UKA was performed in all right knees and lateral UKA was performed in all left knees. All UKA procedures were performed with a computerised navigation system. The tibial internal rotation angle and coronal alignment of the mechanical axis during passive knee flexion were assessed as rotational and varus/valgus kinematics before and after surgery using the navigation system...
March 26, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Richard Storey, Chris Frampton, David Kieser, Ramez Ailabouni, Gary Hooper
OBJECTIVE: This study investigates knee joint arthroplasty and compares the outcomes between attending (consultant) orthopedic surgeons and resident (trainee) surgeons. DESIGN: Retrospective review and comparison of knee joint arthroplasty outcomes between 4 surgeon groups (attending, supervised senior and junior residents, and unsupervised senior residents). Measured outcomes were implant survival (revision rate) and patient reported functional outcomes, measured by Oxford knee score (OKS)...
March 21, 2018: Journal of Surgical Education
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