Unicondylar knee arthroplasty: Key concepts

Halawi, Mohamad J.; Barsoum, Wael K.

doi:10.1016/j.jcot.2016.08.010

Cited by 19 publications

(14 citation statements)

References 30 publications

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“…The geometry of proximal tibia has a direct influence on the biomechanics of knee joint [ 7 ] and the tibial component is recognized to be more prone to complications compared to the femoral component [ 2 , 4 ]. The aspect ratio of the proximal tibia is an important parameter that helps to anticipate the shape of the tibial component.…”

Section: Discussionmentioning

confidence: 99%

“…Arthroplasty is an effective and routinely performed procedure to relieve pain and improve function in patients with osteoarthritis. Unicondylar knee arthroplasty (UKA) for the treatment of localized symptomatic osteoarthritis [ 2 ] while total knee arthroplasty (TKA) for more extensive joint involvement are routine procedures now. Soft-tissue balancing along with optimum coverage of the resected bone surfaces is of prime importance to achieve implant longevity in these procedures.…”

Section: Introductionmentioning

confidence: 99%

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Morphologic Features of the Distal Femur and Proximal Tibia: A Cross-Sectional Study

Chaurasia¹,

Tyagi²,

Santoshi³

et al. 2021

Cureus

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Background The asymmetric medial and lateral condyles of the distal femur and proximal tibia have a direct influence on the biomechanics of knee joint and prostheses design. This study aimed to determine the morphologic data, that is., anteroposterior (AP) and mediolateral (ML) widths, and the radius of curvature (ROC) of the geometric arcs of the distal femur and proximal tibia. Methods One hundred and seventeen adult dry bones (57 femurs and 60 tibias) were studied. Aspect ratios (AP/ML) were calculated. The AP and ML widths were measured using digital Vernier Caliper with a measuring range of 0-150 mm, resolution of 0.01 mm, and accuracy ± 0.02 mm. The geometric arcs of femoral and tibial condyles were divided into three parts namely anterior 1/3rd, distal (femur) or middle (tibia) 1/3rd and posterior 1/3rd and were estimated in the sagittal plane for the femur and transverse plane for tibia using the ROC gauges. Results For the femur, the mean AP length for medial and lateral condyles was 55.62 mm and 57.93 mm, respectively, while the mean ML width was 73.45 mm. For the tibia, the mean AP length for medial condyle (MC) and lateral condyle (LC) was 47.74 mm and 43.46 mm, respectively. The mean aspect ratios for the distal femur and proximal tibia were 1.26 and 1.45, respectively. The mean aspect ratios for MC and LC of the femur were 0.50 and 0.52, respectively, whereas, for tibia, they were 0.61 and 0.71, respectively. The mean ROC for femoral MC - 20.77 mm, 31.42 mm, and 19.68 mm and for LC - 21.48 mm, 64.40 mm and 19.06 mm for the anterior, distal and posterior arcs, respectively. The mean ROC for tibial MC - 22.42 mm, 22.49 mm and 19.94 mm, and LC - 19.92 mm, 21.79 mm and 20.95 mm for the anterior, middle and posterior arcs, respectively. Conclusions The morphologic data accumulated in this study for both the distal femur as well as the proximal tibia would provide guidelines and help the manufacturers of joint prostheses to address the potential for compromised implant fit and re-design and make available ‘anatomic’ knee prostheses appropriate for the local population which would not only improve function but also prolong the longevity of the prostheses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Morphologic Features of the Distal Femur and Proximal Tibia: A Cross-Sectional Study

Chaurasia¹,

Tyagi²,

Santoshi³

et al. 2021

Cureus

View full text Add to dashboard Cite

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“…Despite the rising popularity of UKA [ 42 , 43 ], biomechanical investigations of UKA have been by far less conducted compared with studies including TKA. However, it is often stated that UKA provides normal function and knee kinematics, including axial rotational motion, in contrast to TKA [ 44 – 46 ].…”

Section: Discussionmentioning

confidence: 99%

Compromised knee internal rotation in total knee arthroplasty patients during stair climbing

et al. 2018

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Due to the significant role of rotational properties for normal knee function, this study aimed to investigate transverse plane kinematics and kinetics in total knee arthroplasty and unicondylar knee arthroplasty patients during activities of daily living compared to a healthy control group, including stair ascent and descent. The study participants consisted of a total knee arthroplasty group including posterior cruciate retaining and posterior stabilized designs as well as a unicondylar knee arthroplasty group and a healthy control group. Three-dimensional kinematics and kinetics were captured using a Vicon system and two Kistler force plates embedded in the floor and another two in a staircase. Inverse dynamics of the lower limbs was computed in Anybody™ Modeling System. Transverse plane joint angles and joint moments were analyzed utilizing the statistical non-parametric mapping approach, considering the entire curve shape for statistical analysis. The patients with total knee arthroplasty exhibited significantly reduced knee internal rotation of the operated knee compared to the control group and the patients’ unimpaired limb, especially during the stair climbing tasks. Both unicondylar and total knee arthroplasty patients were found to have similar reduced internal rotation motion time series in stair descent. In conclusion, potential kinematic and kinetic benefits of unicondylar knee arthroplasty over total knee arthroplasty could not be proven in the current study. Aside from the usually mentioned reasons inducing constrained knee internal rotation in total knee arthroplasty patients, future studies should investigate to what extent co-contraction may contribute to this functional impairment in patients after knee arthroplasty surgery.

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“…A study of Stern et al observed that -used correctly -only 8% of patients met all criteria to be eligible [ 2 ]. Currently paradigms are changing, indication criteria are being revised and UKA is used more often [ 1,3 ]. Yet many surgeons still tend to choose total knee arthroplasty (TKA) over UKA due to its proven e cacy, lower revision rates and higher patient satisfaction [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Better Short-term Function After Unicompartmental Compared to Total Knee Arthroplasty

Tille¹,

Beyer²,

Auerbach

et al. 2020

Preprint

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BackgroundUnicompartmental knee arthroplasty (UKA) is an established treatment option for patients with unicompartmental osteoarthritis (OA). However, strict patient selection is crucial for its success. The proposed advantages include nearly natural knee kinematics, faster rehabilitation and better functional outcomes. Despite these facts and it’s proven cost-effectiveness, there are hesitations for the use of UKA as an alternative to total knee arthroplasty (TKA). Key objectives of this study were therefore to assess clinical and patient-reported-outcome (PRO) as well as patient’s satisfaction after medial UKA in comparison to TKA. MethodsTo assess the outcome after UKA we conducted a prospective multi-center study. 116 patients with unicompartmental OA and indication for UKA were included. Overall 54 females and 62 males with an average age of 62.7 years (±9.8) and an average body mass index (BMI) of 29.2 (± 3.7) were recruited. Clinical results and PRO were assessed using the Knee Society Score (KSS). Follow-ups took place 3 months, 1 and 2 years after surgery including clinical examination, radiographs, assessment of PRO and adverse events. Pain and satisfaction were evaluated using a visual analog scale (VAS, 0 (worst) to 10 (best)).For comparison with TKA a propensity score matched-pair analysis was performed to eliminate confounders. Matching criteria were gender, patient´s age, BMI and comorbidities. A total of 116 matched-pairs were analysed. ResultsThere was no revision in the UKA group until 2 years after surgery. Revision rates were higher in the TKA group (0.6%).Preoperative KSS-Scores were higher within the UKA cohort (p < 0.001). After surgical treatment, PROMs displayed a significant improvement (p < 0,001) in both cohorts. Regarding the Knee-Score (Pain, Alignment, ROM) we observed no differences between cohorts after 12 months. The Function-Score demonstrated significantly better results in the UKA cohort (UKA vs. TKA 95 vs 80, p < 0.001). Patient satisfaction was higher in UKA patients (UKA vs TKA 9.0 vs 8.8, p = 0.019).ConclusionPatients of both cohorts showed high satisfaction after knee arthroplasty. UKA resulted in higher function scores compared to TKA without increased revision rate during short-term follow-up. Therefore, UKA is a good treatment option for unicompartmental OA. Trial registrationClinicaltrials.gov, NCT04598568. Registered 22 October 2020 - Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/record/NCT04598568?cond=balanSys+Uni&draw=2&rank=1

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Unicondylar knee arthroplasty: Key concepts

Cited by 19 publications

References 30 publications

Morphologic Features of the Distal Femur and Proximal Tibia: A Cross-Sectional Study

Morphologic Features of the Distal Femur and Proximal Tibia: A Cross-Sectional Study

Compromised knee internal rotation in total knee arthroplasty patients during stair climbing

Better Short-term Function After Unicompartmental Compared to Total Knee Arthroplasty

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