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UKR Surgical Technique: Pearls and Pitfalls

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Small Implants in Knee Reconstruction

Abstract

Before beginning this chapter, perhaps a disclaimer is necessary: I’m not exclusively a knee surgeon, nor is knee surgery the most important and frequent part of my practice. I am neither a designer of the unicompartmental knee replacement (UKR) nor do I receive benefits for implanting them. I’m just saying this because the most frequent accusations, addressed to enthusiast knee surgeons using UKR, are that of expanding the indications and to obtain very positive but non-reproducible results by “normal” surgeons [13]. Likewise, there are surgeons inventors of new designs and models who exaggerate in their choices always with excellent results [48]. However, I believe, indeed, that almost all surgeons can obtain good results by just respecting the correct indications and following some basic rules of surgical technique.

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References

  1. Newman JH, Ackroyd CE, Shah NA (2001) Unicompartmental or total knee replacement? J Bone Joint Surg 80-B:862–865

    Google Scholar 

  2. Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. J Bone Joint Surg Br 91(1):52–7

    Article  PubMed  CAS  Google Scholar 

  3. Swienckowski JJ, Pennington DW (2004) Unicompartmental knee arthroplasty in patients sixty years of age or younger. J Bone Joint Surg 86-A Suppl 1(Pt 2):131–42

    Google Scholar 

  4. Hanssen AD, Dorr LD, Kurosaka M, Maloney WJ, Romagnoli S, Ranawat CS (2002) Case challenges in knee surgery: what would you do? J Arthroplasty 17(4 Suppl 1):83–9

    Article  PubMed  Google Scholar 

  5. Pandit H, Van Duren BH, Gallagher JA, Beard DJ, Dodd CA, Gill HS, Murray DW (2008) Combined anterior cruciate reconstruction and Oxford unicompartmental knee arthroplasty: in vivo kinematics. Knee 15(2):101–6

    Article  PubMed  CAS  Google Scholar 

  6. Heyse TJ, Khefacha A, Peersman G, Cartier P (2011) Survivorship of UKA in the middle-aged. Knee 29 [Epub ahead of print]

    Google Scholar 

  7. Heyse TJ, Khefacha A, Fuchs-Winkelmann S, Cartier P (2011) UKA after spontaneous osteonecrosis of the knee: a retrospective analysis. Arch Orthop Trauma Surg 131(5):613–7

    Article  PubMed  Google Scholar 

  8. Repicci JA (2003) Mini-invasive knee unicompartmental arthroplasty: bone-sparing technique. Surg Technol Int 11:282

    PubMed  Google Scholar 

  9. Confalonieri N, Manzotti A, Pullen C (2007) Navigated shorter incision or smaller implant in knee arthritis? Clin Orthop Relat Res 463:63–7

    PubMed  CAS  Google Scholar 

  10. Confalonieri N, Manzotti A, Montironi F, Pullen C (2008) Tissue sparing surgery in knee reconstruction: unicompartmental (UKA), patellofemoral (PFA), UKA + PFA, bi-unicompartmental (Bi-UKA) arthroplasties. J Orthop Traumatol 9(3):171–7

    Article  PubMed  CAS  Google Scholar 

  11. Kozinn SC, Scott R (1989) Unicondylar knee arthroplasty. J Bone Joint Surg 71A(1):145–50

    Google Scholar 

  12. Assor M, Aubaniac JM (2006) Influence of rotatory malposition of femoral implant in failure of unicompartmental medial knee prosthesis. Rev Chir Orthop Reparatrice Appar Mot 92(5):473–84

    Article  PubMed  CAS  Google Scholar 

  13. Hopkins AR, New AM, Rodriguez-y-Baena F, Taylor M (2010) Finite element analysis of unicompartmental knee arthroplasty. Med Eng Phys 32(1):14–2

    Article  PubMed  Google Scholar 

  14. Jeffery RS, Morris RW, Denham RA (1991) Coronal alignment after total knee replacement. J Bone Joint Surg Br 73(5):709–14

    PubMed  CAS  Google Scholar 

  15. Fehring TK, Odum S, Griffin WL, Mason JB, Nadaud M (2001) Early failures in total knee arthroplasty. Clin Orthop Relat Res (392):315–8

    Article  PubMed  Google Scholar 

  16. Choong PF, Dowsey MM (2011) Update in surgery for osteoarthritis of the knee. Int J Rheum Dis 14(2):167–74

    Article  PubMed  Google Scholar 

  17. Dieppe P, Lim K, Lohmander S (2011) Who should have knee joint replacement surgery for osteoarthritis? Int J Rheum Dis 14(2):175–80

    Article  PubMed  Google Scholar 

  18. Chapple CM, Nicholson H, Baxter GD, Abbott JH (2011) Patient characteristics that predict progression of knee osteoarthritis: a systematic review of prognostic studies. Arthritis Care Res 63(8):1115–25

    Article  Google Scholar 

  19. Telli S, Pinskerova V (2002) The shapes of the tibial and femoral articular surfaces in relation to tibiofemoral movement. J Bone Joint Surg Br 84(4):607–13

    Article  Google Scholar 

  20. Lankester BJ, Cottam HL, Pinskerova V, Eldridge JD, Freeman MA (2008) Variation in the anatomy of the tibial plateau: a possible factor in the development of anteromedial osteoarthritis of the knee. J Bone Joint Surg Br 90(3):330–3

    Article  PubMed  CAS  Google Scholar 

  21. Pinskerova V, Samuelson KM, Stammers J, Maruthainar K, Sosna A, Freeman MA (2009) The knee in full flexion: an anatomical study. J Bone Joint Surg Br 91(6):830–4

    Article  PubMed  CAS  Google Scholar 

  22. Freeman MA, Pinskerova V (2005) The movement of the normal tibio-femoral joint. J Biomech 38(2):197–208

    Article  PubMed  CAS  Google Scholar 

  23. Amis AA, Senavongse W, Darcy P (2005) Biomechanics of patellofemoral joint prostheses. Clin Orthop Relat Res (436):20–9

    Article  PubMed  Google Scholar 

  24. Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Joint Surg Am 86-A(3):506–11

    PubMed  Google Scholar 

  25. Iwaki H, Pinskerova V, Freeman MA (2000) Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg Br 82(8):1189–95

    Article  PubMed  CAS  Google Scholar 

  26. Hill PF, Vedi V, Williams A, Iwaki H, Pinskerova V, Freeman MA (2000) Tibiofemoral movement 2: the loaded and unloaded living knee studied by MRI. J Bone Joint Surg Br 82(8):1196–8

    Article  PubMed  CAS  Google Scholar 

  27. Møller JT, Weeth RE, Keller JO, Nielsen S (1985) Unicompartmental arthroplasty of the knee. Cadaver study of the importance of the anterior cruciate ligament. Acta Orthop Scand 56(2):120–3

    Article  PubMed  Google Scholar 

  28. Dennis D, Komistek R, Scuderi G, Argenson JN, Insall J, Mahfouz M, Aubaniac JM, Haas B (2001) In vivo three-dimensional determination of kinematics for subjects with a normal knee or a unicompartmental or total knee replacement. J Bone Joint Surg Am 83-A Suppl 2 Pt 2:104–15

    Google Scholar 

  29. Argenson JN, Komistek RD, Aubaniac JM, Dennis DA, Northcut EJ, Anderson DT, Agostini S (2002) In vivo determination of knee kinematics for subjects implanted with a unicompartmental arthroplasty. J Arthroplasty 17(8):1049–54

    Article  PubMed  Google Scholar 

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Correspondence to Norberto Confalonieri .

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Confalonieri, N., Manzotti, A. (2013). UKR Surgical Technique: Pearls and Pitfalls. In: Confalonieri, N., Romagnoli, S. (eds) Small Implants in Knee Reconstruction. Springer, Milano. https://doi.org/10.1007/978-88-470-2655-1_5

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  • DOI: https://doi.org/10.1007/978-88-470-2655-1_5

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2654-4

  • Online ISBN: 978-88-470-2655-1

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