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UNICONDYLAR KNEE ARTHROPLASTY (UKA)

15 Oct UNICONDYLAR KNEE ARTHROPLASTY (UKA)

Posted at 07:59h in Uncategorized by
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Unicompartmental knee replacement is a surgical option for isolated medial or lateral compartment osteoarthritis or isolated patelofemoral arthritis. Results of UKA are better than high tibial osteotomy, recovery is quicker and rehabilitation is faster. Knee kinematics is better retained with UKA than TKR(TOTAL KNEE REPLACEMENT).

unicondylar knee replacement

Indication

  • Uni-compartmental osteoarthritis
  • Low-demand senile > 70 years, thin built
  • young patient with moderate arthritis.

Contraindication

  • Varus and valgus deformity > 100
  • Ligament deficiency (ACL)
  • Inflammatory arthritis
  • Tricompartmental osteoarthritis
  • Range of motion < 900
  • Advanced osteoarthritis
  • Post meniscectomy patients
  • High demand high physical activity patients
  • BMI >35
  • Flexion contracture > 150
  • Avascular necrosis
  • Knee subluxation > 1cm in coronal plane, varus thrust gait and incompetent MCL

Types

  • Fixed bearing for lateral side, 1st decade survivorship 88% to 96% but 2nd decade survivorship is relatively less 80% to 90%
  • Mobile bearing reduces contact stress, excellent survivorship 93% at 15 years follow-up.

Techniques

  • Incision at medial border of patella extending distally down to tibia.
  • The of UKA is not to completely correct the varus and to undercirrect to 30 to 4o.of valgus
  • Idea is to give a tibial platform where weight is equally distributed on both the compartment
  • overcorrection or neutral correction causes weight transmission more on the lateral compartment leading to arthritis and failure.
  • Ensure optimal medio-lateral placement of tibial tray and avoid impingement of ACL.

Complication

  • Aseptic loosening
  • Stress fracture
  • Dislocation medial 0.5% and lateral 10%
  • Osteoarthritis progression is the most common cause of revision.

UKA Vs HTO

  • UKA results better than HTO in over 60 years
  • fast rehab and recovery
  • Lasts longer
  • Improved cosmesis
  • Easier to convert to TKA

UKA Vs TKR

  • Better range of motion
  • Less blood loss
  • Easier to revise
  • Better patient satisfaction
  • Shorter hospital stay
  • Knee kinematics preserved
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