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Published byAlaina Hawkins Modified over 9 years ago
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UNICOMPARTMENTAL KNEE PROSTHESIS INDICATIONS
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N. CONFALONIERI ORTHOPAEDIC DEPARTMENT ORTHOPAEDIC AND TRAUMATOLOGIC CENTER MILAN
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-Patients selection -Operative techniques -Prosthetic design -Few complications
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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°
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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)
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UNICOMPARTMENTAL KNEE PROSTHESIS AGE ?
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UNICOMPARTMENTAL KNEE PROSTHESIS RELATIVE CONCEPT !
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UNICOMPARTMENTAL KNEE PROSTHESIS PATELLOFEMORAL JOINT ?
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UNICOMPARTMENTAL KNEE PROSTHESIS RARELY INTACT !
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UNICOMPARTMENTAL KNEE PROSTHESIS JOINT STIFFNESS ?
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UNICOMPARTMENTAL KNEE PROSTHESIS TO BE EVALUATED IN EACH CASE
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UNICOMPARTMENTAL KNEE PROSTHESIS JOINT LAXITY ?
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UNICOMPARTMENTAL KNEE PROSTHESIS ACCORDING TO AGE AND ACTIVITY
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UNICOMPARTMENTAL KNEE PROSTHESIS BODY WEIGHT ?
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UNICOMPARTMENTAL KNEE PROSTHESIS RELATIVE CONCEPT !
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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
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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
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-Patients selection -Operative techniques -Prosthetic design -Few complications
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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 1988 - 2000: 211 cases
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Scala sensorizzata
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Descent Uni fixed bearing (K,1148) Normal dynamic and videomatic (cynematic) Potenza Momento Angolo
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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)
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