Mini-invasive computer assisted bi-unicompartimental knee replacement

Abstract

In the treatment of knee osteoarthritis there are no reports using bi-unicompartimental implants and many orthopaedic surgeons are sceptical about this demanding surgical procedure despite its theoretical advantages in terms of less invasive surgery. The bi-unicompartmental approach also offers the potential advantage of maximal preservation of normal anatomy, with benefits for functional aspects such as gait, muscle activity, and proprioception.Computer-aided knee replacement surgery has been gaining popularity and an improvement in limb alignment and kinematics has been demonstrated in several studies. During the procedure the surgeon can check both implant position and ligament balance during the full range of joint movements, which helps to reduce the complications traditionally associated with failure in the past. The authors present a computer-aided technique for performing bi-unicompartimental knee replacement which permits a less invasive alternative for knee replacement surgery.

Tissue-sparing surgery with the bi-unicompartmental knee prosthesis: retrospective study with minimum follow-up of 36 months

“…Even if this complication was always managed successfully with internal fixation, without influence on the final outcome, we recognise that in these cases the recommended postoperative immobilisation and avoidance of weight bearing do cancel the theoretical advantages of this procedure. Therefore, in 2003, we introduced a computer-assisted technique for bi-UKR to overcome this complication, resulting in better balanced and aligned implants [15].…”

Clinical outcome of bi-unicompartmental knee arthroplasty for both medial and lateral femorotibial arthritis: a systematic review—is there proof of concept?

“…After the initial reports, the criteria for bi-UKA evolved to reflect more contemporary constitutions of patients undergoing knee arthroplasty. In 2005, Confalonieri et al described the typical selection criteria for simultaneous bi-UKA as bi-unicompartmental OA, an asymptomatic patellofemoral joint, ROM greater than 90º, axis deviation less than 10º, and no important anterior or posterior laxity, systemic articular disease, or severe postural defect [30,32]. Obesity, varus deformity associated with osteoporosis, RA, significant symptomatic patellofemoral OA, extreme laxity, and flexion contracture of more than 10º 1 3 [24].…”

Tissue sparing surgery in knee reconstruction: unicompartmental (UKA), patellofemoral (PFA), UKA + PFA, bi-unicompartmental (Bi-UKA) arthroplasties

“…This fracture did not adversely affect the final result. In an attempt to overcome this complication a more precise computer-assisted technique for Bi-UKR has been introduced since 2003 [ 58 ] to achieve a well balance implant both in extension and flexion and with no tension on the ACL tibial insertion.…”