[Successful medial unicompartmental knee arthroplasty-What are the most important surgical tricks?].

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Abstract

[Indexed for MEDLINE] 14. JBJS Essent Surg Tech. 2021 Apr 19;11(2):e20.00002. doi: 10.2106/JBJS.ST.20.00002. eCollection 2021 Apr-Jun. Medial Unicompartmental Knee Arthroplasty with a Mobile-Bearing Implant. Bonano JC(1), Barrett AA(1), Amanatullah DF(1). Author information: (1)Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Redwood City, California. BACKGROUND: For patients with isolated medial knee arthritis, unicompartmental knee arthroplasty (UKA) is an appealing surgical option. Compared with total knee arthroplasty (TKA), UKA is less invasive, preserves more native bone stock, has lower perioperative morbidity and mortality1,2, allows for quicker recovery1,2, and has higher patient satisfaction2,3. It also allows for more dynamic proprioception and postural control, allowing for function more similar to a native knee4. Proper surgical technique and patient selection are critical to the growing success of UKA. DESCRIPTION: The general principles of UKA are to remove and replace the diseased femoral and tibial joint surfaces while restoring limb alignment. The key steps of this procedure are demonstrated in the video article: (1) patient evaluation, (2) patient positioning, (3) surgical exposure, (4) tibial guide placement and resection, (5) femoral guide placement and resection, (6) knee balancing and implant trialing, (7) preventing impingement, (8) final tibial preparation, (9) final component placement, and (10) closure and postoperative course. ALTERNATIVES: Patients should first exhaust all nonoperative treatments before considering UKA. For those patients who do not meet the appropriate indications for UKA, TKA is the most acceptable alternative treatment. In active patients