Patient, Implant, and Alignment Factors Associated With Revision of Medial Compartment Unicondylar Arthroplasty

Collier, Matthew B.; Eickmann, Thomas H.; Sukezaki, Fumio; McAuley, James P.; Engh, Gerard A.

doi:10.1016/j.arth.2006.04.012

Cited by 190 publications

(130 citation statements)

References 28 publications

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“…Despite the success of the procedure, the functional outcomes and survival of UKA are influenced by a variety of factors, including the underlying diagnosis, patient selection, prosthesis design, polyethylene quality, and implant alignment and fixation [1-3, 5, 7-9, 11]. Tibial and femoral component and/or limb malalignment is poorly tolerated in UKA and can jeopardize long-term survival [5,[7][8][9]14]. Swienckowski and Page reported that coronal malalignment of the tibial component beyond 3°predisposed to failure [15].…”

Section: Introductionmentioning

confidence: 99%

“…Hernigou and Deschamps reported a propensity to aseptic failure when the tibial component was implanted with a posterior slope greater than 7°, particularly with a deficient or lax anterior cruciate ligament [9]. Others have reported that the mechanical alignment of the limb, a surrogate of component alignment, can influence the durability of the prosthesis after UKA, although the ideal range of alignment in UKA, and whether under-or overcorrection is better tolerated, remains a source of debate [3,5,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Using a minimally invasive approach with conventional instrumentation, it is difficult to accurately align the tibial component in UKA on a consistent basis [5][6][7]10]. As many as 40% to 60% of components may be malaligned more than 2°from the preoperative plan with conventional methods [4,10].…”

Section: Introductionmentioning

confidence: 99%

“…As many as 40% to 60% of components may be malaligned more than 2°from the preoperative plan with conventional methods [4,10]. Although the precise range of coronal and sagittal component alignment and mechanical axis is not entirely known, there is agreement that variance beyond a safe range can predispose to aseptic loosening of the prosthesis components [3,5,8,9]. Additionally, the range of component alignment varies considerably, even in the hands of skilled knee surgeons [5].…”

Section: Introductionmentioning

confidence: 99%

“…Although the precise range of coronal and sagittal component alignment and mechanical axis is not entirely known, there is agreement that variance beyond a safe range can predispose to aseptic loosening of the prosthesis components [3,5,8,9]. Additionally, the range of component alignment varies considerably, even in the hands of skilled knee surgeons [5]. A study by Collier et al [5] found that of 245 medial UKAs, the mean tibial component varus was 8°± 3°(range, À5°to +21°) and the mean posterior tibial component slope was 9°± 4°(range, À2°to +21°).…”

Section: Introductionmentioning

confidence: 99%

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Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study

Lonner

John

Conditt³

2010

Clinical Orthopaedics &Amp; Related Research

190

114

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The alignment of the components of unicompartmental knee arthroplasty (UKA) reportedly influences outcomes and durability. A novel robotic arm technology has been developed with the expectation that it could improve the accuracy of bone preparation in UKA. During the study period, we compared the postoperative radiographic alignment of the tibial component with the preoperatively planned position in 31 knees in 31 consecutive patients undergoing UKA using robotic arm-assisted bone preparation and in 27 consecutive patients who underwent unilateral UKA using conventional manual instrumentation to determine the error of bone preparation and variance with each technique. Radiographically, the root mean square error of the posterior tibial slope was 3.1°w hen using manual techniques compared with 1.9°when using robotic arm assistance for bone preparation. In addition, the variance using manual instruments was 2.6 times greater than the robotically guided procedures. In the coronal plane, the average error was 2.7°± 2.1°more varus of the tibial component relative to the mechanical axis of the tibia using manual instruments compared with 0.2°±

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study

Lonner

John

Conditt³

2010

Clinical Orthopaedics &Amp; Related Research

190

114

View full text Add to dashboard Cite

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Importance of joint line preservation in unicompartmental knee arthroplasty: Finite element analysis

Kwon

Kang

Son

et al. 2016

Journal Orthopaedic Research

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Unicompartmental knee arthroplasty (UKA) is an effective surgical technique for pain relief and functional restoration in patients with localized osteoarthritis of the knee joint. However, the role of the joint line in UKA, especially its biomechanical effect, has not been previously investigated. This study numerically evaluates the effects of the joint line on the contact stresses in polyethylene (PE) inserts, articular cartilage, and lateral meniscus using the finite element (FE) analysis. The FE model for joint line was modeled as the orthogonal projection line from the medial tibial plateau to the anatomical axis. The joint line was varied from -6 to +6 mm in 2 mm intervals, and the seven FE models were analyzed and compared under ISO gait loading conditions. The contact stresses in the PE insert, articular cartilage, and lateral meniscus matched those of the reference joint line (0 mm) in the ±2 and ±4 mm joint line cases but significantly differed from the reference in the ±6 mm joint line cases. On the +6 mm joint line, the contact stress was greater on the PE insert than on the articular cartilage, whereas the reverse occurred on the -6 mm joint line. This study confirms the post-operative significance of joint line preservation in UKA implantation surgery. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:347-352, 2017.

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A systematic review of MAKO‐assisted unicompartmental knee arthroplasty

Lin

Yan

et al. 2020

Robotics Computer Surgery

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Unicompartmental knee arthroplasty (UKA), which has many potential advantages compared with total knee arthroplasty, was widely used across the world in recent years. The introduction of the robot systems greatly makes up for the defects of the conventional UKA surgery such as higher complication rates and revision rates. MAKO system, a new image-guided robot system relies on a preoperative computed tomography scan to assist in preoperative mapping and planning, offers an opportunity to improve the outcome of UKA surgeries. In order to have a more comprehensive and in-depth understanding of MAKO-assisted UKA, the studies on MAKO-assisted UKA were summarized. MAKO-assisted UKA is better than conventional UKA surgery on implant accuracy, soft tissue balance, patient function scores and satisfaction, complications rates, and learning curve in short-term outcome; however, the mid-term and long-term outcomes of MAKO-assisted UKA need to be further studied.

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Patient, Implant, and Alignment Factors Associated With Revision of Medial Compartment Unicondylar Arthroplasty

Cited by 190 publications

References 28 publications

Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study

Robotic Arm-assisted UKA Improves Tibial Component Alignment: A Pilot Study

Importance of joint line preservation in unicompartmental knee arthroplasty: Finite element analysis

A systematic review of MAKO‐assisted unicompartmental knee arthroplasty

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