UNICOMPARTMENTAL KNEE PROSTHESIS INDICATIONS. N. CONFALONIERI ORTHOPAEDIC DEPARTMENT ORTHOPAEDIC AND TRAUMATOLOGIC CENTER MILAN.

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Presentation transcript:

UNICOMPARTMENTAL KNEE PROSTHESIS INDICATIONS

N. CONFALONIERI ORTHOPAEDIC DEPARTMENT ORTHOPAEDIC AND TRAUMATOLOGIC CENTER MILAN

-Patients selection -Operative techniques -Prosthetic design -Few complications

INDICATIONS: Unicomp. arthrosis Unicomp. arthrosis Intact controlateral compartment Intact controlateral compartment (Ist and 2d Ahlback’s classes) (Ist and 2d Ahlback’s classes) Asimptomatic patellofemoral joint Asimptomatic patellofemoral joint ROM > 90° ROM > 90° Axial deformity < 15° Axial deformity < 15°

INDICATIONS: Flexion deformity < 5° Flexion deformity < 5° Age > 60 y. Age > 60 y. Body Weight: < 82 kg Body Weight: < 82 kg No joint laxity (intact ACL) No joint laxity (intact ACL) No pain at rest No pain at rest No systemic disorders No systemic disorders (reumathoid arthr., hemophilia) (reumathoid arthr., hemophilia)

UNICOMPARTMENTAL KNEE PROSTHESIS AGE ?

UNICOMPARTMENTAL KNEE PROSTHESIS RELATIVE CONCEPT !

UNICOMPARTMENTAL KNEE PROSTHESIS PATELLOFEMORAL JOINT ?

UNICOMPARTMENTAL KNEE PROSTHESIS RARELY INTACT !

UNICOMPARTMENTAL KNEE PROSTHESIS JOINT STIFFNESS ?

UNICOMPARTMENTAL KNEE PROSTHESIS TO BE EVALUATED IN EACH CASE

UNICOMPARTMENTAL KNEE PROSTHESIS JOINT LAXITY ?

UNICOMPARTMENTAL KNEE PROSTHESIS ACCORDING TO AGE AND ACTIVITY

UNICOMPARTMENTAL KNEE PROSTHESIS BODY WEIGHT ?

UNICOMPARTMENTAL KNEE PROSTHESIS RELATIVE CONCEPT !

UNICOMPARTMENTAL KNEE PROSTHESIS CONTROINDICATIONS: Flexion deformity > 15° Flexion deformity > 15° Osteoporosis + Obesity + Deformity Osteoporosis + Obesity + Deformity Technical errors: - polyetylene < 6 mm Technical errors: - polyetylene < 6 mm - ipercorrection - ipercorrection - hip disease - hip disease

UNICOMPARTMENTAL KNEE PROSTHESIS CONTROINDICATIONS: Reumathoid arthr., Hemophilia Reumathoid arthr., Hemophilia Serious joint laxity Serious joint laxity Serious varus deformity Serious varus deformity Serious symptomatic patello-femoral Serious symptomatic patello-femoral arthritis arthritis

-Patients selection -Operative techniques -Prosthetic design -Few complications

COMPLICATIONS DVT: 4 (1.8%)DVT: 4 (1.8%) CONDILE FRACTURES: 1 tibial (0.4%)CONDILE FRACTURES: 1 tibial (0.4%) 1 femoral (0.4%) 1 femoral (0.4%) SUPERFICIAL INFECTIONS: 6 (2.8%)SUPERFICIAL INFECTIONS: 6 (2.8%) SYNOVITIS: 3 (1.1%)SYNOVITIS: 3 (1.1%) UNICOMPARTMENTAL KNEE PROSTHESIS : 211 cases

Scala sensorizzata

Descent Uni fixed bearing (K,1148) Normal dynamic and videomatic (cynematic) Potenza Momento Angolo

CONCLUSIONS Most patients with UKA walked with a more normal gait pattern than patients with TKA. Some worrisome radiographic findings will require careful long term evalutation to assess UKA longevity and utility. J.O. Galante (1996)