F von Knoch1, U Munzinger. 1. Gelenkzentrum Zürich, Toblerstr. 51, 8044, Zürich, Schweiz, vonknoch@gelenkzentrum.com.
Abstract
BACKGROUND: Unicondylar knee arthroplasty (UKA) is an established therapeutic option for advanced medial or lateral gonarthrosis. OBJECTIVES: The cornerstones of a successful UKA, careful patient selection, preoperative planning and precise operation technique, are discussed in this overview article. IMPORTANCE: In contrast to total knee arthroplasty, UKA allows preservation of the contralateral and patellofemoral compartments as well as the cruciate ligaments and is often associated with rapid postoperative recovery, improved knee kinematics and knee function. However, UKA is technically very demanding. High revision rates have been reported in particular with widespread application, according to national joint replacement registries. CONCLUSION: Successful UKA relies on meticulous patient selection, preoperative planning and surgical technique. It is justified to broaden classic UKA indications. In medial and lateral UKA three types of mechanical varus-valgus deformity can be encountered: type 1 (isolated intraarticular deformity), type 2 (pronounced deformity due to extraarticular varus deformity in medial UKA or valgus deformity in lateral UKA), type 3 (reduced deformity due to extraarticular valgus deformity in medial UKA or varus deformity in lateral UKA). We believe these deformities should be addressed accordingly with surgical technique.
BACKGROUND:Unicondylar knee arthroplasty (UKA) is an established therapeutic option for advanced medial or lateral gonarthrosis. OBJECTIVES: The cornerstones of a successful UKA, careful patient selection, preoperative planning and precise operation technique, are discussed in this overview article. IMPORTANCE: In contrast to total knee arthroplasty, UKA allows preservation of the contralateral and patellofemoral compartments as well as the cruciate ligaments and is often associated with rapid postoperative recovery, improved knee kinematics and knee function. However, UKA is technically very demanding. High revision rates have been reported in particular with widespread application, according to national joint replacement registries. CONCLUSION: Successful UKA relies on meticulous patient selection, preoperative planning and surgical technique. It is justified to broaden classic UKA indications. In medial and lateral UKA three types of mechanical varus-valgus deformity can be encountered: type 1 (isolated intraarticular deformity), type 2 (pronounced deformity due to extraarticular varus deformity in medial UKA or valgus deformity in lateral UKA), type 3 (reduced deformity due to extraarticular valgus deformity in medial UKA or varus deformity in lateral UKA). We believe these deformities should be addressed accordingly with surgical technique.
Authors: Michael Clarius; Christian Hauck; Joern B Seeger; Andrew James; David W Murray; Peter R Aldinger Journal: Int Orthop Date: 2009-02-14 Impact factor: 3.075
Authors: Richard A Berger; R Michael Meneghini; Joshua J Jacobs; Mitchell B Sheinkop; Craig J Della Valle; Aaron G Rosenberg; Jorge O Galante Journal: J Bone Joint Surg Am Date: 2005-05 Impact factor: 5.284
Authors: Adam Boissonneault; Hemant Pandit; Elise Pegg; Cathy Jenkins; Harinderjit Singh Gill; Christopher A F Dodd; Christopher L M H Gibbons; David W Murray Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-07-11 Impact factor: 4.342
Authors: Thomas M Grupp; Matthias F Pietschmann; Melanie Holderied; Christian Scheele; Christian Schröder; Volkmar Jansson; Peter E Müller Journal: Clin Biomech (Bristol, Avon) Date: 2013-10-10 Impact factor: 2.063