Unicompartmental Porous Coated Anatomic Total Knee Arthroplasty

Tl, Bernasek; Ja, Rand; Rs, Bryan

doi:10.1097/00003086-198811000-00007

Cited by 41 publications

(12 citation statements)

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“…In terms of clinical relevance, it is not possible to apply a conforming design to the tibial insert when a customized UKA is developed. Bernasek et al reported unsatisfactory results regarding the insertion of the same type of conforming fixed-bearing UKA [47]. Furthermore, a previous study indicated that significant degenerative changes in the other compartments occurred in only one of the eighty-seven knees in which an unconstrained UKA was implanted [48].…”

Section: Discussionmentioning

confidence: 99%

Influence of Preservation of Normal Knee Contact Stress on Other Compartments with respect to the Tibial Insert Design for Unicompartmental Knee Arthroplasty

Koh

Kang

2019

Applied Bionics and Biomechanics

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Recent advances in imaging technology and additive manufacturing have led to the introduction of customized unicompartmental knee arthroplasty (UKA) that can potentially improve functional performance due to customized geometries, including customized sagittal and coronal curvature and enhanced bone preservation. The purpose of this study involved evaluating the biomechanical effect of the tibial insert design on the customized medial UKA using computer simulations. We developed sagittal and coronal curvatures in a native knee mimetic femoral component design. We utilized three types of tibial insert design: flat, anatomy mimetic, and conforming design. We evaluated contact stress on the tibial insert and other compartments, including the lateral meniscus and articular cartilage, under gait and squat loading conditions. For the conforming UKA design, the tibial insert and lateral meniscus exhibited the lowest contact stress under stance phase gait cycle. However, for the conforming UKA design, the tibial insert and lateral meniscus exhibited the highest contact stress under swing phase gait cycle. For the flat UKA design, the articular cartilage exhibited the lowest contact stress under gait and squat loading conditions. The anatomy mimetic UKA design exhibited the most normal-like contact stress on the other compartments under gait and squat loading conditions. The results reveal the importance of conformity between the femoral component and the tibial insert in the customized UKA. Based on the results on the femoral component as well as the tibial insert in the customized UKA, the anatomy mimetic design preserves normal knee joint biomechanics and thus may prevent progressive osteoarthritis of the other knee compartments.

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Section: Discussionmentioning

confidence: 99%

Influence of Preservation of Normal Knee Contact Stress on Other Compartments with respect to the Tibial Insert Design for Unicompartmental Knee Arthroplasty

Koh

Kang

2019

Applied Bionics and Biomechanics

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“…The most observed complication is osteoarthritis in the patellofemoral joint [7] [8]. Impingement was observed in four knees in which only one knee was revised in front of major pain and incapacity.…”

Section: Discussionmentioning

confidence: 99%

Patellofemoral Outcome after Medial Unicompartmental Knee Replacement: A Retrospective Study of 25 Cases

Naouar¹,

Kaziz²,

Mouelhi³

et al. 2017

OJO

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Introduction: Osteoarthritis and impingement, in patellofemoral compartment after partial arthroplasty, have been rarely reported. The purpose of our study was to evaluate outcome at long-term follow-up. Methods: We have reviewed retrospectively twenty-five unicompartmental arthroplasties. The medial parapatellar approach was used in all cases. Patients have been evaluated with regard to patellar impingement and osteoarthritic changes revealed by radiographs. The mean follow-up was 10.4 years. The clinical scoring system of the Knee Society and specific questions regarding patellofemoral symptoms were used for functional outcome. Patellofemoral complications such as osteoarthritis, impingement and the position of the femoral component were diagnosed on X-ray views of the knee. Results: At the final follow-up, fifteen knees revealed lateral patellofemoral osteoarthritis and four knees had patellofemoral impingement. Excepted of two cases, all knees with patella impingement did not revealed degenerative modifications. Anterior pain of the knee was noted more frequently in knees with patellar complications. Patellar impingement was considered the first cause of knee pain, more than knees with degenerative modifications. Only one revision surgery was indicated in front of patellofemoral conflict. The occurrence of patellar impingement depends on the surgical procedure. The anterior position of the femoral component seems to increase the frequency of such complication.

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“…In terms of clinical relevance, tibial insert conformity should not be designed well in a PS UKA design because high conformity cannot lead to natural knee kinematics. Previous studies have shown that fixed-bearing UKA leads to poor functional results after an insertion-constrained tibial insert [60,61]. We recommend that conformity of the tibial insert should be followed with the current anatomy in the PS UKA design.…”

Section: Biomed Research Internationalmentioning

confidence: 91%

Finite Element Study on the Preservation of Normal Knee Kinematics with Respect to the Prosthetic Design in Patient-Specific Medial Unicompartmental Knee Arthroplasty

Koh

Kang

2020

BioMed Research International

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Alterations in native knee kinematics in medial unicompartmental knee arthroplasty (UKA) are caused by the nonanatomic articular surface of conventional implants. Technology for an anatomy mimetic patient-specific (PS) UKA has been introduced. However, there have been no studies on evaluating the preservation of native knee kinematics with respect to different prosthetic designs in PS UKA. The purpose of this study was to evaluate the preservation of native knee kinematics with respect to different UKA designs using a computational simulation. We evaluated three different UKA designs: a nonconforming design, an anatomy mimetic design, and a conforming design for use under gait and squat loading conditions. The results show that the anatomy mimetic UKA design achieves closer kinematics to those of a native knee compared to the other two UKA designs under such conditions. The anatomy memetic UKA design exhibited a 0.39 mm and 0.36° decrease in the translation and rotation, respectively, in the swing phase compared with those of the natural knee. In addition, under the gait and squat loading conditions, the conforming UKA design shows limited kinematics compared to the nonconforming UKA design. Our results show that the conformity of each component in PS UKA is an important factor in knee joint kinematics; however, the anatomy mimetic UKA design cannot restore perfect native kinematics.

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Unicompartmental Porous Coated Anatomic Total Knee Arthroplasty

Cited by 41 publications

References 0 publications

Influence of Preservation of Normal Knee Contact Stress on Other Compartments with respect to the Tibial Insert Design for Unicompartmental Knee Arthroplasty

Influence of Preservation of Normal Knee Contact Stress on Other Compartments with respect to the Tibial Insert Design for Unicompartmental Knee Arthroplasty

Patellofemoral Outcome after Medial Unicompartmental Knee Replacement: A Retrospective Study of 25 Cases

Finite Element Study on the Preservation of Normal Knee Kinematics with Respect to the Prosthetic Design in Patient-Specific Medial Unicompartmental Knee Arthroplasty

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