Superior femoral component alignment can be achieved with Oxford microplasty instrumentation after minimally invasive unicompartmental knee arthroplasty

Tu, Yihui; Xue, Hao; Ma, Tiancai; Wen, Tao; Yang, Tao; Zhang, Hui; Cai, Minwei

doi:10.1007/s00167-016-4173-3

Cited by 29 publications

(32 citation statements)

References 26 publications

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“…This evolution is driven by the desire to achieve consistent implant positioning as well as optimal sizing, and accelerate rehabilitation. The currently used Microplasty instrumentation is designed to implant the components through a minimally invasive approach while ensuring accurate positioning [9,11,12].…”

Section: Introductionmentioning

confidence: 99%

Femoral Component Sizing in Oxford Unicompartmental Knee Replacement: Existing Guidelines Do Not Work for Indian Patients

et al. 2018

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Oxford unicompartmental knee replacement (OUKR) has shown excellent long-term clinical outcomes as well as implant survival when used for correct indications with optimal surgical technique. Anteromedial osteoarthritis is highly prevalent in Indian patients, and OUKR is the ideal treatment option in such cases. Uncertainty prevails about the best method to determine femoral component size in OUKR. Preoperative templating has been shown to be inaccurate, while height- and gender-based guidelines based on European population might not apply to the Indian patients. Microplasty instrumentation introduced in 2012 introduced the sizing spoon, which has the dual function of femoral component sizing and determining the level of tibia cut. We aimed to check the accuracy of sizing spoon and also to determine whether the present guidelines are appropriate for use in the Indian patients. A total of 130 consecutive Oxford mobile bearing medial cemented UKR performed using the Microplasty instrumentation were included. The ideal femoral component size for each knee was recorded by looking for overhang and underhang in post-operative lateral knee radiograph. The accuracy of previous guidelines was determined by applying them to our study population. Previously published guidelines (which were based on Western population) proved to be accurate in only 37% of cases. Hence, based on the demographics of our study population, we formulated modified height- and gender-based guidelines, which would better suit the Indian population. Accuracy of modified guidelines was estimated to be 74%. The overall accuracy of sizing spoon (75%), when used as an intraoperative guide, was similar to that of modified guidelines. Existing guidelines for femoral component sizing do not work in Indian patients. Modified guidelines and use of intraoperative spoon should be used to choose the optimal implant size while performing OUKR in Indian patients.

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Section: Introductionmentioning

confidence: 99%

Femoral Component Sizing in Oxford Unicompartmental Knee Replacement: Existing Guidelines Do Not Work for Indian Patients

et al. 2018

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“…An estimated 200 000 total hip and knee arthroplasty operations were carried out in 2012, and the number increased to more than 580 000 in 2017. Although UKA has been carried out for decades in Europe and North America, it has only recently become available in China and, thus, is only carried out in a few centers, with limited short‐term outcomes reported. It is not clear how many patients with end‐stage knee OA in China might be suitable for UKA and PFJR.…”

Section: Introductionmentioning

confidence: 99%

Patterns of Compartment Involvement in End‐stage Knee Osteoarthritis in a Chinese Orthopedic Center: Implications for Implant Choice

Sun

Palmer

Liu

et al. 2018

Orthopaedic Surgery

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“…In 2012, new microplasty instruments were introduced for OUKA, making the surgery more reliable and reproducible [8,10,11]. The microplasy operation technique of the phase 3 OUKA rstly proposed the method of using ASIS as reference for anatomical axis of femur in UKA [7], which showed great superiority in femoral alignment [12] and was later accepted by most of surgeons engaged in UKA operation. Before this, surgeons used to take the center of femoral head as the reference for MA so as to guide the resection of tibia in UKA.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of anterior superior iliac spine (ASIS) as reference for anatomical axis of femur in Unicompartmental knee arthroplasty

Yan

Cheng

et al. 2020

Preprint

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Purpose：We aim to figure out the deviation of using ASIS as the reference for femoral anatomical axis (AA) in unicompartmental knee arthroplasty (UKA) and the degree of angle between AA and actual mechanical axis (MA) in the coronal plane for patients with medial compartment knee osteoarthritis (KOA). Patients and Methods： Between December 2017 to December 2019, a total of 120 consecutive knees (104 patients) with severe medial compartment KOA were included in this study. The weight-bearing full-length radiographs of included knees were analyzed using Picture Archiving Communication System (PACS). The lines of AA, operation AA (oAA) and MA were identified. Angles between AA and oAA (Angle 1), AA and MA (Angle 2) were measured on the radiographs. Symbol “+” and ”-” were attached with angles between AA and oAA to describe the situation when oAA lies in the lateral or medial side of AA. The statistical analysis was done using SPSS Version 23.0. A p values＜0.05 were considered to be significant. Results: The deviation angle between AA and oAA in the coronal plane (Angle 1) was (0.91±1.08)° (-2.61°-3.04°). The angle between AA and MA in the coronal plane (Angle 2) was (6.26±1.01）° (3.95°-8.93°). No significant differences of Angle 1 and Angle 2 were found between sexes. For knees with partial thickness cartilage loss (PTCL) (n=39) and full thickness cartilage loss (FTCL) (n=81), Angle 1 was statistically significantly different in the 120 knees (0.61°vs.1.05°;p=0.035). While the Angle 2 for knees with PTCL and FTCL was (6.13±0.80)° (4.83°-7.99°, p=0.326) and (6.32±1.09)° (3.95°-8.93°, p=0.326), respectively. Conclusion：A mean deviation angle of 0.91° was identified between AA and oAA, the value of which could be larger in knees with FTCL. ASIS may not be a reliable reference for AA of femur in UKA patients. And an adjustment of at most 1.0°of varus angle may help achieve better coronal alignment.

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Superior femoral component alignment can be achieved with Oxford microplasty instrumentation after minimally invasive unicompartmental knee arthroplasty

Abstract: Therapeutic study, Level IV.

Cited by 29 publications

References 26 publications

Femoral Component Sizing in Oxford Unicompartmental Knee Replacement: Existing Guidelines Do Not Work for Indian Patients

Femoral Component Sizing in Oxford Unicompartmental Knee Replacement: Existing Guidelines Do Not Work for Indian Patients

Patterns of Compartment Involvement in End‐stage Knee Osteoarthritis in a Chinese Orthopedic Center: Implications for Implant Choice

The efficacy of anterior superior iliac spine (ASIS) as reference for anatomical axis of femur in Unicompartmental knee arthroplasty

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