Einzeltreffer — DigiBib

Purpose: The purpose of this study was to demonstrate the clinical utility of controlled posterior condylar milling (CPCM) in gap balancing while minimally resecting the tibia during fixed-bearing unicompartmental knee arthroplasty (UKA).

Methods: This study is a retrospective cohort study. Patients who underwent medial UKA for isolated medial compartment osteoarthritis with a minimum follow-up of 2 years were included. The patients were divided into two groups: the conventional group (n = 56) and the CPCM group (n = 66). In the CPCM group, the proximal tibia was resected at the level of the distal end of the subchondral bone. If the flexion gap was tighter than extension, the posterior condyle was additionally milled to adjust gap tightness. Standing knee X-ray and scanogram were used to evaluate alignment and tibia resection amount. Range of motion (ROM) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores were used to evaluate clinical outcomes.

Results: The CPCM group showed significantly smaller tibia resection (3.6 ± 1.9 mm) compared to the conventional group (5.2 ± 2.7 mm) (p < 0.001). Postoperative ROM (133.0 ± 8.3°, 135.2 ± 7.2°, n.s.) and WOMAC (19.3 ± 13.6, 23.6 ± 17.7, n.s.) were not significantly different between the two groups. Postoperative periprosthetic fractures occurred in two patients in conventional group, while the CPCM group had no periprosthetic fractures.

Conclusion: The CPCM technique may be a simple and useful intraoperative technique that can achieve minimal tibia resection and promising clinical outcomes while easily adjusting gap tightness between flexion and extension during medial fixed-bearing UKA.

Level of Evidence: Level III.

Titel:	Controlled posterior condylar milling technique for unicompartmental knee arthroplasty minimises tibia resection during gap balancing: Short-term clinical results.
Autor/in / Beteiligte Person:	Koh, JH ; Lim, S ; Park, JY ; Chung, JY ; Jin, YJ ; Yun, HW ; Noh, S ; Park, DY
Zeitschrift:	Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, Jg. 32 (2024-02-01), Heft 2, S. 499-508
Veröffentlichung:	2024- : [Hoboken] : Wiley ; <i>Original Publication</i>: [Heidelberg, Germany] : Springer International, c1993-, 2024
Medientyp:	academicJournal
ISSN:	1433-7347 (electronic)
DOI:	10.1002/ksa.12029
Schlagwort:	Humans Tibia surgery Knee Joint surgery Retrospective Studies Range of Motion, Articular Arthroplasty, Replacement, Knee methods Osteoarthritis, Knee surgery Knee Prosthesis
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Knee Surg Sports Traumatol Arthrosc] 2024 Feb; Vol. 32 (2), pp. 499-508. <i>Date of Electronic Publication: </i>2024 Jan 19. MeSH Terms: Arthroplasty, Replacement, Knee* / methods ; Osteoarthritis, Knee* / surgery ; Knee Prosthesis* ; Humans ; Tibia / surgery ; Knee Joint / surgery ; Retrospective Studies ; Range of Motion, Articular References: Klasan, A., Luger, M., Hochgatterer, R. & Young, S.W. (2022) Measuring appropriate need for unicompartmental knee arthroplasty: results of the MANUKA study. Knee Surgery, Sports Traumatology, Arthroscopy, 30, 3191-3198. ; Kyriakidis, T., Asopa, V., Baums, M., Verdonk, R. & Totlis, T. (2023) Unicompartmental knee arthroplasty in patients under the age of 60 years provides excellent clinical outcomes and 10-year implant survival: a systematic review: a study performed by the Early Osteoarthritis group of ESSKA-European Knee Associates section. Knee Surgery, Sports Traumatology, Arthroscopy, 31, 922-932. ; Douiri, A., Bouguennec, N., Biset, A., Colombet, P., Laboudie, P. & Graveleau, N. (2023) Functional scores and prosthetic implant placement are different for navigated medial UKA left in varus alignment. Knee Surgery, Sports Traumatology, Arthroscopy, 31, 3919-3926. ; Kamenaga, T., Hiranaka, T., Nakano, N., Hayashi, S., Fujishiro, T., Okamoto, K. et al. (2022) Short distance from the keel to the posterior tibial cortex is associated with fracture after cementless Oxford UKA in Asian patients. Knee Surgery, Sports Traumatology, Arthroscopy, 30, 1220-1230. ; Woiczinski, M., Schröder, C., Paulus, A., Kistler, M., Jansson, V., Müller, P.E. et al. (2020) Varus or valgus positioning of the tibial component of a unicompartmental fixed-bearing knee arthroplasty does not increase wear. Knee Surgery, Sports Traumatology, Arthroscopy, 28, 3016-3021. ; Wurm, A., Zechling, A., Leitner, H., Dammerer, D., Pfeifer, B., Krismer, M. et al. (2022) Medial unicondylar knee arthroplasty should be reserved for patients with complete joint space collapse. Knee Surgery, Sports Traumatology, Arthroscopy, 30, 3162-3167. ; Small, S.R., Berend, M.E., Rogge, R.D., Archer, D.B., Kingman, A.L. & Ritter, M.A. (2013) Tibial loading after UKA: evaluation of tibial slope, resection depth, medial shift and component rotation. The Journal of Arthroplasty, 28, 179-183. ; Thoreau, L., Morcillo Marfil, D. & Thienpont, E. (2022) Periprosthetic fractures after medial unicompartmental knee arthroplasty: a narrative review. Archives of Orthopaedic and Trauma Surgery, 142, 2039-2048. ; Heyse, T.J., El-Zayat, B.F., De Corte, R., Scheys, L., Chevalier, Y., Fuchs-Winkelmann, S. et al. (2016) Balancing UKA: overstuffing leads to high medial collateral ligament strains. Knee Surgery, Sports Traumatology, Arthroscopy, 24, 3218-3228. ; Malhotra, R., Gupta, S., Gupta, V. & Manhas, V. (2021) Navigated unicompartmental knee arthroplasty: a different perspective. Clinics in Orthopedic Surgery, 13, 491-498. ; Mortman, R., Gioia, C., Stake, S., Berger, P.Z., Gu, A., Fassihi, S.C. et al. (2021) Linked kinematic knee balancing in unicompartmental knee arthroplasty. Journal of Orthopaedics, 24, 182-185. ; Zhang, Q.D., Liu, Z.H., Wang, W.G., Zhang, Q., Cheng, L.M. & Guo, W.S. (2019) A modified technique for tibial bone sparing in unicompartmental knee arthroplasty. Chinese Medical Journal, 132, 2690-2697. ; Adulkasem, N., Rojanasthien, S., Siripocaratana, N. & Limmahakhun, S. (2019) Posterior tibial slope modification in osteoarthritis knees with different ACL conditions: cadaveric study of fixed-bearing UKA. Journal of Orthopaedic Surgery, 27, 230949901983628. ; Khow, Y.Z., Liow, M.H.L., Lee, M., Chen, J.Y., Lo, N.N. & Yeo, S.J. (2022) Posterior condylar offset and posterior tibial slope targets to optimize knee flexion after unicompartmental knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 30, 822-831. ; Gharaibeh, M.A., Monk, E., Chen, D.B. & MacDessi, S.J. (2018) Evaluation of the patellofemoral joint in total knee arthroplasty: validation of the weight bearing merchant radiographic view. The Knee, 25, 1262-1271. ; Negrin, R., Duboy, J., Reyes, N.O., Barahona, M., Iniguez, M., Infante, C. et al. (2020) Robotic-assisted Unicompartmental knee Arthroplasty optimizes joint line restitution better than conventional surgery. Journal of Experimental Orthopaedics, 7, 94. ; Ishii, Y., Noguchi, H., Takeda, M., Ishii, H. & Toyabe, S.I. (2011) Changes in the medial and lateral posterior condylar offset in total knee arthroplasty. The Journal of Arthroplasty, 26, 255-259. ; Choudhury, P., Billings, S.J., Bestic, J.M., Peterson, J.J., Stanborough, R.O., Garner, H.W. et al. (2023) Radiologists should use the hip-knee-ankle angle rather than the mechanical axis deviation to describe knee alignment. Skeletal Radiology, 52, 1159-1167. ; Tseng, T.H., Wang, H.Y., Tzeng, S.C., Hsu, K.H. & Wang, J.H. (2022) Knee-ankle joint line angle: a significant contributor to high-degree knee joint line obliquity in medial opening wedge high tibial osteotomy. Journal of Orthopaedic Surgery and Research, 17, 79. ; Chen, Y., Ding, J., Dai, S., Yang, J., Wang, M., Tian, T. et al. (2022) Radiographic measurement of the posterior tibial slope in normal Chinese adults: a retrospective cohort study. BMC Musculoskeletal Disorders, 23, 386. ; Leung, Y.Y., Thumboo, J., Yeo, S.J., Wylde, V. & Tannant, A. (2022) Validation and interval scale transformation of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in patients undergoing knee arthroplasty, using the Rasch model. Osteoarthritis and Cartilage Open, 4, 100322. ; Kuroda, Y., Takayama, K., Ishida, K., Hayashi, S., Hashimoto, S., Tsubosaka, M. et al. (2018) Medial joint line elevation of the tibia measured during surgery has a significant correlation with the limb alignment changes following medial unicompartmental knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 26, 3468-3473. ; Pornrattanamaneewong, C., Ruangsillapanan, N., Ruangsomboon, P., Narkbunnam, R., Chareancholvanich, K. & Udomkiat, P. (2023) No association between different in tibial resection level and clinical outcomes six months after Oxford unicompartmental knee arthroplasty: a prospective cohort study. BMC Musculoskeletal Disorders, 24, 3. ; Kim, T.K., Mittal, A., Meshram, P., Kim, W.H. & Choi, S.M. (2021) Evidence-based surgical technique for medial unicompartmental knee arthroplasty. Knee Surgery & Related Research, 33, 2. ; Tay, M.L., McGlashan, S.R., Monk, A.P. & Young, S.W. (2022) Revision indications for medial unicompartmental knee arthroplasty: a systematic review. Archives of Orthopaedic and Trauma Surgery, 142, 301-314. ; van der List, J.P., Zuiderbaan, H.A. & Pearle, A.D. (2016) Why do medial unicompartmental knee arthroplasties fail today? The Journal of Arthroplasty, 31, 1016-1021. ; Pegg, E.C., Walter, J., D'Lima, D.D., Fregly, B.J., Gill, H.S. & Murray, D.W. (2020) Minimising tibial fracture after unicompartmental knee replacement: a probabilistic finite element study. Clinical Biomechanics, 73, 46-54. ; Houskamp, D.J., Tompane, T. & Barlow, B.T. (2020) What Is the critical tibial resection depth during unicompartmental knee arthroplasty? a biomechanical study of fracture risk. The Journal of Arthroplasty, 35, 2244-2248. ; Lu, C., Ye, G., Liu, W., Wu, H., Wu, G. & Chen, J. (2019) Tibial plateau fracture related to unicompartmental knee arthroplasty: two case reports and literature review. Medicine, 98, e17338. ; El-Galaly, A., Kappel, A., Nielsen, P.T. & Jensen, S.L. (2019) Revision risk for total knee arthroplasty converted from medial unicompartmental knee arthroplasty: comparison with primary and revision arthroplasties, based on mid-term results from the danish knee arthroplasty registry. Journal of Bone and Joint Surgery, 101, 1999-2006. ; Thienpont, E. (2017) Conversion of a unicompartmental knee arthroplasty to a total knee arthroplasty: can we achieve a primary result? The Bone & Joint Journal, 99-B, 65-69. ; Sun, X. & Su, Z. (2018) A meta-analysis of unicompartmental knee arthroplasty revised to total knee arthroplasty versus primary total knee arthroplasty. Journal of Orthopaedic Surgery and Research, 13, 158. ; Lee, Y.S., Kim, H.J., Mok, S.J. & Lee, O.S. (2019) Similar outcome, but different surgical requirement in conversion total knee arthroplasty following high tibial osteotomy and unicompartmental knee arthroplasty: a meta-analysis. The Journal of Knee Surgery, 32, 686-700. ; Kato, K., Ogawa, H., Matsumoto, K. & Akiyama, H. (2021) Surgical procedures for the prevention of extension-flexion gap imbalance in total knee arthroplasty. Journal of Orthopaedics, 25, 224-229. ; Takayama, K., Ishida, K., Muratsu, H., Kuroda, Y., Tsubosaka, M., Hashimoto, S. et al. (2018) The medial tibial joint line elevation over 5 mm restrained the improvement of knee extension angle in unicompartmental knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 26, 1737-1742. ; Koh, Y.G., Park, K.M., Kang, K., Kim, P.S., Lee, Y.H., Park, K.K. et al. (2021) Finite element analysis of the influence of the posterior tibial slope on mobile-bearing unicompartmental knee arthroplasty. The Knee, 29, 116-125. ; Liddle, A.D., Pandit, H., Judge, A. & Murray, D.W. (2015) Optimal usage of unicompartmental knee arthroplasty: a study of 41,986 cases from the National Joint Registry for England and Wales. The Bone & Joint Journal, 97-B, 1506-1511. ; Inui, H., Taketomi, S., Yamagami, R., Kono, K., Kawaguchi, K., Takagi, K. et al. (2020) Femorotibial rotational mismatch of the Oxford unicompartmental knee in the flexion position is a risk for poor outcomes. The Knee, 27, 1064-1070. ; Liow, M.H.L., Tsai, T.Y., Dimitriou, D., Li, G. & Kwon, Y.M. (2016) Does 3-dimensional in vivo component rotation affect clinical outcomes in unicompartmental knee arthroplasty? The Journal of Arthroplasty, 31, 2167-2172. Grant Information: 2023R1A2C1007200 National Research Foundation (NRF) funded by the Korean Government (MSIT); 22C0601L1 Korean Fund for Regenerative Medicine (KFRM) grant funded by the Korean government (the Ministry of Science and ICT, the Ministry of Health & Welfare Contributed Indexing: Keywords: arthroplasty; knee; osteoarthritis; unicompartmental knee arthroplasty Entry Date(s): Date Created: 20240119 Date Completed: 20240214 Latest Revision: 20240214 Update Code: 20240214

Klicken Sie ein Format an und speichern Sie dann die Daten oder geben Sie eine Empfänger-Adresse ein und lassen Sie sich per Email zusenden.

BibTeX Citavi, JabRef, u.a.
(Literaturverwaltung)

PDF kein Volltext!
(Merkzettel, Notizen)

RIS Endnote, Citavi u.a.
(Literaturverwaltung)

MODS
(XML zur Weiterverarbeitung)

oder

Wählen Sie das für Sie passende Zitationsformat und kopieren Sie es dann in die Zwischenablage, lassen es sich per Mail zusenden oder speichern es als PDF-Datei.

Gewünschter Zitations-Stil:

oder

Bitte prüfen Sie, ob die Zitation formal korrekt ist, bevor Sie sie in einer Arbeit verwenden. Benutzen Sie gegebenenfalls den "Exportieren"-Dialog, wenn Sie ein Literaturverwaltungsprogramm verwenden und die Zitat-Angaben selbst formatieren wollen.

Controlled posterior condylar milling technique for unicompartmental knee arthroplasty minimises tibia resection during gap balancing: Short-term clinical results.