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Lateral unicompartmental knee arthroplasty with mechanical instrumentation : tips and tricks to guarantee excellent long-term outcomes

Published in N°011 - May / June 2021
Article viewed 108 times

Lateral unicompartmental knee arthroplasty with mechanical instrumentation : tips and tricks to guarantee excellent long-term outcomes

By Etienne Deroche(1), Roger Badet(2), Franck Remy(3), Sébastien Lustig(1) in category SURGICAL TECHNIQUE
(1) Department of Orthopaedic Surgery, Hôpital de la Croix-Rousse, Claude Bernard Lyon 1 University, 103 Grande rue de la Croix-Rousse, 69004, Lyon, France. - (2) St Charles Clinic, Lyon /Fleming Orthopaedic Clinic, Bourgoin Jallieu, France. - (3) St Omer Clinic, 71 rue Ambroise Paré, Blendecques, France.

Lateral unicompartmental knee arthroplasty (UKA) is ten times less common than medial UKA. This is primarily due to the lower prevalence of the valgus morphotype within the general population. There are numerous reasons for isolated lateral tibiofemoral primary osteoarthritis, but it is mainly caused by a valgus morphotype...

Introduction

Lateral unicompartmental knee arthroplasty (UKA) is ten times less common than medial UKA. This is primarily due to the lower prevalence of the valgus morphotype within the general population. There are numerous reasons for isolated lateral tibiofemoral primary osteoarthritis, but it is mainly caused by a valgus morphotype, lateral femoral condylar hypoplasia and aggravated by obesity. Secondary osteoarthritis is mainly a result of trauma, meniscectomy or spontaneous osteonecrosis (SPONK) of tibia or femur. [1,2]

However, once the indication for surgical replacement has been decided, many surgeons still favour total knee arthroplasty (TKA) through fear of having to revise the UKA a few years down the line. These reserves are often based on the results of clinical studies, in which the survival rates were worse compared to TKA and the complications of unexplained pain, dislocation of the polyethylene component when a mobile-bearing insert had been used, early loosening of progression of OA in the other compartments.[3]

There has been a resurgence of interest in UKA ever since functional outcomes for the medial compartment began to outperform TKA, with low long-term revision rates and lower morbidity (bleeding, hospitalisation time and perioperative...

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