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A modified technique for tibial bone sparing in unicompartmental knee arthroplasty.

ABSTRACT: BACKGROUND:Previously, the authors modified the surgical technique to preserve tibial bone mass for Oxford unicompartmental knee arthroplasty (UKA). The purpose of this study was to determine the clinical outcomes and values of this modified technique. METHODS:Clinical data of 34 consecutive patients who underwent the unilateral modified UKA technique (modified group, 34 knees) were retrospectively analyzed. To compare the outcome, a match-paired control group (conventional group, 34 knees) of an equal number of patients using the conventional technique system in the same period were selected and matched with respect to diagnosis, age, pre-operative range of motion (ROM), and radiological grade of knee arthrosis. Clinical outcomes including knee Hospital for Special Surgery (HSS) score, ROM, and complications were compared between the two groups. Post-operative radiographic assessments included hip-knee-ankle angle (HKA), joint line change, implant position, and alignment. RESULTS:The mean follow-up time was 38.2?±?6.3 months. There was no difference in baseline between the two groups. The amount of proximal tibial bone cut in the modified group was significantly less than that of the conventional group (4.7?±?1.1?mm vs. 6.7?±?1.3?mm, t?=?6.45, P?

SUBMITTER: Zhang QD

PROVIDER: S-EPMC6940103 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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A modified technique for tibial bone sparing in unicompartmental knee arthroplasty.

Zhang Qi-Dong QD Liu Zhao-Hui ZH Wang Wei-Guo WG Zhang Qian Q Cheng Li-Ming LM Guo Wan-Shou WS

Chinese medical journal 20191101 22

<h4>Background</h4>Previously, the authors modified the surgical technique to preserve tibial bone mass for Oxford unicompartmental knee arthroplasty (UKA). The purpose of this study was to determine the clinical outcomes and values of this modified technique.<h4>Methods</h4>Clinical data of 34 consecutive patients who underwent the unilateral modified UKA technique (modified group, 34 knees) were retrospectively analyzed. To compare the outcome, a match-paired control group (conventional group, ...[more]

PMID: 31765355

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Project description:BACKGROUND:The mobile Oxford unicompartmental knee arthroplasty (UKA) implant has been widely used with an intramedullary guide for femoral preparation. We modified the femoral guide technique based on the tibial cut first and spacer block technique. This study was performed to determine the radiographic accuracy and early clinical outcomes of the extramedullary method. METHODS:We retrospectively evaluated 50 consecutive patients who underwent UKA using the extramedullary technique. An equal number of patients who underwent UKA with the conventional technique were matched as the control group. Clinical outcomes were evaluated in terms of the operating time, blood loss, range of motion, and Hospital for Special Surgery score. Radiographic accuracy was evaluated by the implant position and alignment in the coronal and sagittal planes. RESULTS:The mean follow-up period was 39.76 ± 5.77?months. There were no differences in the postoperative Hospital for Special Surgery score, range of motion, or hip-knee-ankle angle between the two groups. The operating time in the extramedullary group was shorter than that in the conventional group (54.78 ± 7.95 vs. 59.14 ± 10.91?min, respectively; p = 0.025). The drop in hemoglobin after 3?days was only 12.34 ± 4.98?g/L in the extramedullary group which was less than that in the conventional group (p = 0.001). No significant differences were found in the postoperative coronal and sagittal angles between the two groups. Acceptable radiographic accuracy of the implant alignment and position was achieved in 92% of patients in the extramedullary group and 96% of patients in the conventional group. CONCLUSIONS:The radiographic and clinical results of the extramedullary technique were comparable with those of the conventional technique with the advantage of no intramedullary interruption, less blood loss, a shorter operating time, and more rapid recovery. As the technique depends on the accurate tibial cut and overall alignment, we do not recommend it to surgeons without high volume experiences. TRIAL REGISTRATION:Retrospectively registered LEVEL OF EVIDENCE: IV, retrospective study.

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A modified technique for tibial bone sparing in unicompartmental knee arthroplasty.

Publications

A modified technique for tibial bone sparing in unicompartmental knee arthroplasty.

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