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Medial unicompartimental knee arthroplasty : Indications and limits

Published in N°007 - September / October 2020
Article viewed 29 times

Medial unicompartimental knee arthroplasty : Indications and limits

By Caroline DEBETTE in category PEDAGOGY
Clinique Protestante, Lyon

Medial unicompartmental knee arthroplasty (UKA) is currently one of the preferred surgical treatments for medial unicompartmental osteoarthritis of the knee, lying between a total replacement and osteotomy.

 

Medial unicompartmental knee arthroplasty (UKA) is currently one of the preferred surgical treatments for medial unicompartmental osteoarthritis of the knee, lying between a total replacement and osteotomy.

After initial failures, it took the obstinacy of surgeons who kept faith in the UKA, an improvement in techniques and tribology, and the refinement of indications and contraindications to raise the success rate of UKA, which now is nearly on a par with total knee arthroplasty.

However, ever since Kozinn published an article on the indications and limits of medial UKA in 1989,1 the procedure has suffered from fuzzy overlapping theories and constantly-changing opinions which together with its previous poor reputation, has been scaring off surgeons.
Where are we now? Is there an ideal patient? How far can we push the limits?

The best indication is medial tibiofemoral osteoarthritis AND no contraindications. Contraindications are what lead to failure. It is therefore important to look at the causes of failure in order to determine first the limits of this procedure, and then the indications.

Authors have reported widely on the failures of medial UKA. Apart from avoidable technical errors, the main causes of failure derive from poor patient selection. These two observations...

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