Unicompartmental Knee Arthroplasty
The idea of unicompartmental knee arthroplasty (UKA) was first conceived by McKeever and Elliot in 1952 while doing work to develop metallic tibial plateau prostheses. In 1958, McIntosh reported (22) the use of a prosthesis with a vitallium tibial plateau
- PDF / 1,433,785 Bytes
- 7 Pages / 612 x 794 pts Page_size
- 48 Downloads / 219 Views
Unicompartmental Knee Arthroplasty Nikolaus M. Boehler Orthopaedische Abteilung Lin:
The idea of unicompartmental knee arthroplasty (UKA) was first conceived by McKeever and Elliot in 1952 while doing work to develop metallic tibi al plateau pro stheses. In 1958 , McIntosh reported (22) the use of a prosthesis with a vitallium tibial plateau. At the John Charnley Clinic , Gunston developed a pla stic and metal pro sthesis during the earl y 70 s. Thi s type of pro sthe sis was modified by the May o Clinic and called the "Polycentric Knee ." Marmor carried out most of the earl y scientific work on UK A. He created his own "Marmor pro sthesis," developed the correct ind ica tion s, and in 1977 began publishing studies (11 ).
Halfway through the 80s , discussion surrounding the use of UKA was controversial due to the fact that Insall and Aglietti ( 15) pub lished unsati sfactory re sult s. On the other hand , Cartier, Scott (7 , 29) and many others co uld demonstrate that they had instead obt ained satisfactory results. The controversy continue s today, but after learning about the technic al principles and careful indications of the method, I am co nvinced that there will always be a pla ce for UKA .
Indications Man y countries are still discu ssing whether there is a place for UKA at all , while at the sa me time the re sults obtained when the meth od is used are more and more con vinc ing . There are two different standpoints: 1. Against use of UKA : it is best to repl ace T. P. Sculco et al. (eds.), Knee Arthroplasty © Springer-Verlag/Wien 2001
the ent ire knee, as the other compartments will eventually wear out. 2. For use of UKA: it is a basic principle of orthopaedics to save all of the normal tissue , knowing that any device used will always be inferior to the natural joint. For those who believe in UKA , patient selection is one of the most important factors in achi eving good results. The traditional ind ication is osteonecrosis of the femoral condyle (Ahlbaeck's disea se). In patients with this patholo gy, the deci sion whether or not to implant a UKA can ea sil y be made by X-ray asses sment or MRT. In patients with knee s with degenerative arthriti s, patient selection must be done carefully, monitoring several criteria.
Criteria Related to the General Circumstances of the Patients Patients below the age of 60 years should only be sele cted for the use of UKA under special circumstances . The best candidates are not acti ve patients over the age of 70 , or tho se with multiple degenerative joint involvement. Heavy patients, exceeding 80 kg in weight, and patients engaged in demanding sports activities are poor candidates for UKA . In younger, heavy or very active patients, a high tibial osteotomy, over the age of 70, and total knee replacement might be favored. On the other hand , UKA is more predictable if it is compared to high tibial osteotomy; early results are much more satisfying, and postoperative rehabilitation remains shorter. Therefore, even in patients aged under 60 years, UKA might be used
Data Loading...
