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

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Presentation on theme: "UNICOMPARTMENTAL KNEE PROSTHESIS INDICATIONS. N. CONFALONIERI ORTHOPAEDIC DEPARTMENT ORTHOPAEDIC AND TRAUMATOLOGIC CENTER MILAN."— Presentation transcript:

1 UNICOMPARTMENTAL KNEE PROSTHESIS INDICATIONS

2 N. CONFALONIERI ORTHOPAEDIC DEPARTMENT ORTHOPAEDIC AND TRAUMATOLOGIC CENTER MILAN

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

4 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°

5 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)

6 UNICOMPARTMENTAL KNEE PROSTHESIS AGE ?

7 UNICOMPARTMENTAL KNEE PROSTHESIS RELATIVE CONCEPT !

8 UNICOMPARTMENTAL KNEE PROSTHESIS PATELLOFEMORAL JOINT ?

9 UNICOMPARTMENTAL KNEE PROSTHESIS RARELY INTACT !

10 UNICOMPARTMENTAL KNEE PROSTHESIS JOINT STIFFNESS ?

11 UNICOMPARTMENTAL KNEE PROSTHESIS TO BE EVALUATED IN EACH CASE

12 UNICOMPARTMENTAL KNEE PROSTHESIS JOINT LAXITY ?

13 UNICOMPARTMENTAL KNEE PROSTHESIS ACCORDING TO AGE AND ACTIVITY

14 UNICOMPARTMENTAL KNEE PROSTHESIS BODY WEIGHT ?

15 UNICOMPARTMENTAL KNEE PROSTHESIS RELATIVE CONCEPT !

16 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

17 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

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

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27 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

28 Scala sensorizzata

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

30 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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