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Unicondylar knee arthroplasty

Richard L Purcell, John P Cody, Deborah J Ammeen, Nitin Goyal, Gerard A Engh
INTRODUCTION: Unicompartmental knee arthroplasty (UKA) is an effective alternative to total knee arthroplasty (TKA) for the management of unicondylar osteoarthritis. Historical contraindications limit patients' eligibility for UKA. However, recent reports have suggested that some contraindications may not be absolute. This study evaluates preoperative flexion contracture with regard to UKA. METHODS: This study was a retrospective review of 53 patients with preoperative flexion contracture between 11° and 20° who underwent fixed-bearing UKA and a matched cohort of 53 patients who underwent cruciate-retaining TKA...
February 27, 2018: Journal of the American Academy of Orthopaedic Surgeons
S Miller, A Agarwal, W B Haddon, L Johnston, G Arnold, W Wang, R J Abboud
Introduction The aim of this study was to compare kinetical data from gait analysis of patients who have undergone total and uni-condylar knee replacement. Materials and methods Thirteen patients with unilateral total knee arthroplasty (TKA) and 13 unicondylar knee arthroplasty (UKA), were included, all performed by the same surgeon more than one year prior. The Vicon gait analysis system was used. Statistical power was calculated using SPSS. Results No significant difference was found in the spatiotemporal parameters of gait and survival years of the knee prosthesis between the two groups...
February 27, 2018: Annals of the Royal College of Surgeons of England
Hannah Castle, Kon Kozak, Aman Sidhu, Riaz J K Khan, Samantha Haebich, Vanessa Bowden, Daniel P Fick, Hari Goonatillake
Knee range of motion (ROM) following a knee arthroplasty is an important clinical outcome that directly relates to the patient's physical function. Smartphone technology has led to the creation of applications that can measure ROM. The aim was to determine the concurrent reliability and validity of the photo-based application 'Dr Goniometer' (DrG) compared with a universal goniometer performed by a clinician. A smartphone camera was used to take photographs of the knee in full flexion and full extension, and the images were sent by participants to a study phone...
February 20, 2018: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
T Walker, N Zahn, T Bruckner, M R Streit, G Mohr, P R Aldinger, M Clarius, T Gotterbarm
AIMS: The aim of this independent multicentre study was to assess the mid-term results of mobile bearing unicondylar knee arthroplasty (UKA) for isolated lateral osteoarthritis of the knee joint. PATIENTS AND METHODS: We retrospectively evaluated 363 consecutive, lateral UKAs (346 patients) performed using the Oxford domed lateral prosthesis undertaken in three high-volume knee arthroplasty centres between 2006 and 2014. Mean age of the patients at surgery was 65 years (36 to 88) with a mean final follow-up of 37 months (12 to 93) RESULTS: A total of 36 (10...
January 2018: Bone & Joint Journal
Dietmar Dammerer, Michael Liebensteiner, Hannes Rochau, Christian Uprimny, Vinzenz Smekal, Ralf Rosenberger, Elvire Servien
BACKGROUND: Previous studies reported that in partial knee arthroplasty smooth transitions to the remaining native parts of the knee are important. However, in mobile-bearing unicondylar knee arthroplasty (UKA) it is mandatory to create an anterior osteochondral notch adjacent to the femoral component to get clearance for the anterior lip of the bearing in full knee extension. This notch is, however, part of the femoral trochlea. It was the aim of the study to test for a potential association between a) an obligatory anterior notch in mobile-bearing UKA located at the margin of the medial aspect of the femoral trochlea and b) postoperative patellofemoral joint (PFJ) bone remodelling and discomfort...
December 16, 2017: BMC Musculoskeletal Disorders
Edwin P Su, Lauren E Mount, Allina A Nocon, Thomas P Sculco, George Go, Nigel E Sharrock
BACKGROUND: Total knee arthroplasty (TKA) is associated with a risk of thromboembolism requiring routine thromboprophylaxis, but there is debate about the risk with unicondylar knee arthroplasty (UKA) as it is a more minor procedure. We sought to investigate the relative risk of thromboembolism with UKA compared to TKA and one-staged bilateral TKA (BTKA) by measuring the increase in circulating biochemical markers of thrombin generation during the procedures. Degree of surgical trauma was also assessed by measuring interleukin-6, a marker of metabolic injury...
March 2018: Journal of Arthroplasty
Daniel C Wascher
No abstract text is available yet for this article.
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
Florian Baumann, Werner Krutsch, Michael Worlicek, Maximilian Kerschbaum, Johannes Zellner, Paul Schmitz, Michael Nerlich, Carsten Tibesku
PURPOSE: There is rising impact of patient-reported outcome (PRO) measurement in joint arthroplasty over the past years. Bicruciate-retaining implants have shown more physiologic knee kinematics and provide superior proprioceptive capacities. The aim of this study was to evaluate if the functional properties of this new implant design lead to improved PRO results after total knee arthroplasty (TKA). METHODS: This prospective, controlled trial compares PRO of bicruciate-retaining total knee arthroplasty (BCR-TKA) to unicondylar knee arthroplasty (UKA) and standard posterior-stabilized total knee arthroplasty (PS-TKA)...
November 9, 2017: Archives of Orthopaedic and Trauma Surgery
Akshay Lakra, Taylor Murtaugh, Jeffrey A Geller, William Macaulay, Roshan P Shah
BACKGROUND: Patients with unicompartmental radiographic arthritis but bicompartmental symptoms pose a clinical challenge. Some surgeons may perceive it as a contraindication for unicondylar knee arthroplasty (UKA). We investigated patient outcomes 2 years after simultaneous ipsilateral arthroscopy and UKA as compared to a similar group of patients who had total knee replacement (TKA) for a similar clinical presentation. METHODS: We identified 9 patients with simultaneous ipsilateral arthroscopy and UKA between 2004 and 2013, and 12 clinically similar patients treated with TKA...
December 2017: Journal of Orthopaedics
Elke Jeschke, Thorsten Gehrke, Christian Günster, Karl-Dieter Heller, Jürgen Malzahn, Axel Marx, Fritz-Uwe Niethard, Peter Schräder, Josef Zacher, Andreas Matthias Halder
Background Reported survival rates of unicondylar knee arthroplasty (UKA) vary considerably. The influences of patient characteristics and the type of implant have already been examined. This analysis investigated the influence of hospital volume on 5-year-survival rate, using administrative claims data of Germany's largest health insurance provider. Methods We analysed administrative claims data for 20,946 UKAs covered by the German local healthcare funds (Allgemeine Ortskrankenkasse, AOK) between 2006 and 2012...
August 23, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
Eli Kamara, Zachary P Berliner, Matthew S Hepinstall, H John Cooper
BACKGROUND: There has been a great increase in the use of navigation technology in joint arthroplasty. In most types of navigation-assisted surgery, several temporary navigation pins are placed in the patient. Goals of this study are (1) to identify complications and (2) risk factors associated with placement of these pins. METHODS: This is a retrospective cohort study of all navigation-assisted hip and knee arthroplasty performed a single institution over a 3-year period...
April 20, 2017: Journal of Arthroplasty
Mohamad J Halawi, Wael K Barsoum
The concept of unicondylar knee arthroplasty (UKA) has been described as early as 1950s following the introduction of the MacIntosh and McKeever hemiarthroplasty. With improvements in implant design, patient selection, and surgical technique, there has been an increase in utilization of UKA as a less-invasive alternative to total joint arthroplasty for the treatment of localized symptomatic osteoarthritis. The purpose of this review article is to highlight five trending concepts in UKA based on current evidence: bearing design, fixation technique, medial vs...
January 2017: Journal of Clinical Orthopaedics and Trauma
Roland Becker, Michael Hirschmann
No abstract text is available yet for this article.
March 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
R Becker, C Paech, A Denecke
OBJECTIVE: The unicondylar prosthesis replaces the medial femerotibial compartment only, the part presenting with osteoarthritic changes. The remaining compartments of the knee present less osteoarthritic changes and thus can be preserved. INDICATIONS: Osteoarthritis of the medial femorotibial compartment is the ideal indication for unicondylar arthroplasty. The knee should show an intraarticular deformity, which means the malalignment is caused by the osteoarthritic changes of the medial compartment...
February 2017: Operative Orthopädie und Traumatologie
Thomas J Heyse, Joshua Slane, Geert Peersman, Margo Dirckx, Arne van de Vyver, Philipp Dworschak, Susanne Fuchs-Winkelmann, Lennart Scheys
PURPOSE: The recently reintroduced bicruciate-retaining Total Knee Arthroplasty (BCR TKA) is an interesting approach in the quest for close replication of knee joint biomechanics and kinematics closer to the native knee. Therefore, this study aimed at providing a detailed biomechanical view on the functional resemblance of BCR TKA to the native knee joint. METHODS: Seven fresh-frozen full leg cadaver specimens (76 ± 10 year) were mounted in a 6 degrees-of-freedom kinematic rig that applied a dynamic squatting motion knee flexion...
June 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Vikas Kulshrestha, Barun Datta, Santhosh Kumar, Gaurav Mittal
BACKGROUND: With increasing number of patients with early osteoarthritis of knee opting for total knee arthroplasty (TKA), there has been increase in patients dissatisfied with surgical outcomes. It is being presumed that offering unicondylar knee arthroplasty (UKA) to them would improve outcomes. METHODS: Primary objective of our study was to look for any difference in patient-reported outcome and function at 2-year follow-up in patients undergoing UKA as compared to TKA...
May 2017: Journal of Arthroplasty
Andrew S Longenecker, Gregory S Kazarian, Giovanni P Boyer, Jess H Lonner
BACKGROUND: Obtaining routine radiographs in the postanesthesia care unit (PACU) after primary uncomplicated partial knee arthroplasty (PKA) is a common practice with unclear utility. The objective of this study is to determine the rate at which immediate postoperative radiographs identify an actionable problem after primary uncomplicated PKA and to determine the potential cost savings associated with foregoing the routine acquisition of these radiographs. METHODS: This was a retrospective review that assessed a consecutive series of 1366 primary uncomplicated PKAs (including 873 unicondylar knee arthroplasties, 313 patellofemoral arthroplasties, and 180 bicompartmental knee arthroplasties) performed between January 2008 and March 2016...
May 2017: Journal of Arthroplasty
N Oehler, T Schmidt, A Niemeier
Background: An increasing number of physically active patients not only need to know if they will basically be able to engage in sports after undergoing arthroplasty. They also would like to know whether or not they will be able to resume their preoperative activity levels. This article aims to provide an overview of recent data regarding the following questions on hip, knee and shoulder arthroplasty: (1) What is the impact of physical activity on an endoprosthesis? (2) What level of sports can be achieved after an arthroplasty procedure? (3) What types of sport are recommended for patients with an endoprosthesis? Methods: PubMed-based review of the literature...
December 2016: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
T Walker, P R Aldinger, M R Streit, T Gotterbarm
OBJECTIVE: Joint surface replacement in the lateral compartment by unicondylar knee arthroplasty. INDICATIONS: Lateral unicompartmental osteoarthritis of the knee joint, avascular necrosis of the lateral femoral condyle. CONTRAINDICATIONS: Full thickness cartilage defect in the central part of the medial compartment or in the medial aspect of the patellofemoral joint. Instability/contracture of cruciate and collateral ligaments, valgus deformity >15°, valgus deformity not passively correctable, flexion deformity >15°, an intraoperative flexion <100°, failed upper tibial osteotomy, rheumatoid arthritis...
February 2017: Operative Orthopädie und Traumatologie
Elke Jeschke, Thorsten Gehrke, Christian Günster, Joachim Hassenpflug, Jürgen Malzahn, Fritz Uwe Niethard, Peter Schräder, Josef Zacher, Andreas Halder
BACKGROUND: Improvements in implant design and surgical technique of unicondylar knee arthroplasty have led to reduced revision rates, but patient selection seems to be crucial for success of such arthroplasties. The purpose of the present study was to analyze the 5-year implant survival rate of unicondylar knee replacements in Germany and to identify patient factors associated with an increased risk of revision, including >30 comorbid conditions. METHODS: Using nationwide billing data of the largest German health-care insurance for inpatient hospital treatment, we identified patients who underwent unicondylar knee arthroplasty between 2006 and 2012...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
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