Navigated Unicompartmental Knee Replacement

Abstract

The author developed a non-image-guided navigation system for unicompartmental knee replacement that can be used with conventional surgery or minimally invasive surgery. The author performed a radiological analysis of the accuracy of implantation for unicompartmental knee replacement with conventional surgery, navigated minimally invasive surgery, and conventional navigated surgery. A significant increase in the rate of prostheses implanted in the desired angular range for all criteria in conventional navigated minimally invasive surgery and conventional navigated surgery was found. The conventional navigated technique was significantly more accurate than minimally invasive surgery.

Predicting anterior cruciate ligament integrity in patients with osteoarthritis

“…If assessment of the ACL is limited to visual inspection at arthroscopy only, this study suggests therefore it is possible that some patients who receive a UKR have a macroscopically normal but histologically and functionally abnormal ACL. This may be a relevant factor in unexpected failure of some patients undergoing such a procedure [9].…”

Assessment of accuracy of robotically assisted unicompartmental arthroplasty

“…Unicompartmental knee arthroplasty (UKA) has recently found re‐emergence for the treatment of knee arthritis, especially effecting the medial compartment [4, 24]. However, the minimal invasive approach to UKA is technically challenging with reduced visibility of bony landmarks used for sizing and alignment [3, 12, 13, 17, 19, 27]. Survival of UKA is mainly dependent on component position; malalignment of the prosthesis may result in poor post‐operative function and progressive wear leading to early revision surgery [1, 4, 7, 9, 14, 15, 35].…”

“…Navigated and robotic-assisted UKA has been shown to improve component alignment and post-operative ligament balancing [2,5,10,16,[18][19][20][21][22][23][30][31][32][33]. Dunbar et al measured the accuracy of component placement with the use of a robotic-assisted system on post-operative CT scans in 20 UKAs [11].…”

“…Components were placed within 1.6 mm and 3°of the pre-operative plan. However, component placement was compared to preoperative CT measurements by the robotic systems, a comparison between the actual intra-operative plan and post-operative alignment has not been performed [5,10,[17][18][19][20][21]24].…”

Superior alignment but no difference in clinical outcome after minimally invasive computer-assisted unicompartmental knee arthroplasty (MICA-UKA)

“…The rationale for combining computer‐assisted UKA and mini‐invasive techniques is that the reduction in perioperative morbidity and the improvement in early post‐operative function that are achieved with less invasive exposures can be realized while retaining the accuracy of implant and limb alignment that can be achieved with computer techniques, even when crucial surgical anatomical landmarks are not visible [1, 4–7, 17, 19, 21]. Despite some encouraging evidence in the literature, the clinical benefits of MICA‐UKA are still unclear.…”