Influence of mini approach instrumentation on component alignment in unicondylar knee replacement.

Dr Vinod Kumar, Dr Deepak Gupta, Dr Ananya Sharma
Department of Orthopaedics, MAMC and Lok Nayak Hospital, New Delhi 110002.

AIM- to evaluate the accuracy of placements of implants using mini approach instrumentation.
Methods- It was an Interventional Prospective Clinical Study in thirty-three knees of primary Symptomatic Medial compartment osteoarthritis having full thickness articular cartilage loss with or without bone loss in the medial compartment. On AP views, the alignments of the femoral and tibial components were measured. On lateral views, flexion/extension of the femoral and tibial component was. A 7° posterior–inferior tilt of the tibial component was taken as neutral. Tilting beyond this gave a positive value, whereas tilting less than this was negative.

Summary- Position of varus/ valgus femoral component (recommended range of alignment as 10° varus to 10° valgus) was within acceptable ranges in all the patients with a mean of 4.21° varus (SD:2.98°, range:3.3° valgus to 8.6° varus).
Position of flexion/ extension femoral component (recommended range of alignment as 5° extension to 10° flexion) was within acceptable ranges in 72.73% of knees with a mean of 7.21° flexion (SD:4.3°, range:1.2° flexion to 14.4° flexion). Posterior fit of femoral component with proposed acceptable range of 0 to 4 mm posterior overhang was achieved in all patients except three with mean: 0.73 mm overhang (range 1 mm short to 2.5 mm overhang). Medial/ lateral fit of femoral component was achieved in 54.55% of knees with the mean femoral component placement was 0.82 mm lateral (range: 1 mm medial to 5 mm lateral). Position of varus/valgus tibial component (recommended range of alignment as 5° varus to 5° valgus) was achieved in 54.55% patients with mean alignment of 5.8° varus (SD:3.89°, range:3° valgus to 13.2° varus).
Superior/ Inferior tilt of tibial component (recommended range of alignment from 5° superior tilt to 5° inferior tilt) was achieved in 72.73% of the knees with mean tibial alignment was 3.6° superior tilt. Anterior fit of tibial component of all except three patient, were within the acceptable range (flush or <5mm short). Posterior fit of tibial component was 0.2 mm short (range: 3 mm short to 2 mm overhang). This was achieved in 72.73% of patients. Medial fit of tibial component was 0.4 mm short (range: 2 mm short to flush). Nine patients were outside the acceptable range of medial fit of tibial component. Lateral fit of tibial component of all patients were within the acceptable range. Meniscal bearings were placed centrally in all the patients.

Conclusion- Components of UKR i.e. Femoral component, Tibial component and Meniscal bearing can be placed with high accuracy using mini-approach instrumentation. In this study, two implant position namely Femoral central position and Tibia varus alignment had maximum error rate. This can be attributed to technical errors and learning surgical curve.

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Intraoperative Varus-Valgus Joint Laxity Pattern Was Associated With Postoperative Knee Flexion Angle and Patient-Reported Outcome Measures in Bicruciate-Stabilized Total Knee Arthroplasty. ePoster Presentation Ryota Yamagami, MD, JAPAN Kenichi Kono, MD, PhD, JAPAN Kohei Kawaguchi, MD, PhD, JAPAN Tomofumi Kage, JAPAN Ryo Murakami, MD, JAPAN Takahiro Arakawa, MD, JAPAN Hiroshi Inui, PhD, JAPAN Shuji Taketomi, MD, PhD, JAPAN Sakae Tanaka, MD, PhD, JAPAN
Does 1000 Mg Ferric Carboxylate Maltose Have an Additional Benefit on the Haemoglobin Recovery Post Total Knee Arthroplasty? - A Comparison with 500 Mg of Ferric Carboxymaltose ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Ashwini Khokhar, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Naveen Chandar, MBBS, INDIA Abhinav Mishra, MS, DNB, INDIA Rajesh Maniar, INDIA
Novel Technique For Surgeon-Placed Nerve Block And Continuous Nerve Block In Total Knee Arthroplasty. A Cadaveric Study ePoster Presentation Daniel E Matthews, MD, FAAOS, UNITED STATES
Intra- And Inter-Operator Reliability Assessment Of A Novel Extramedullary Accelerometer-Based Smart Cutting-Guide For Total Knee Arthroplasty: An In-Vivo Study ePoster Presentation Stefano Zaffagnini, MD, Prof., ITALY Domenico Alesi, MD, ITALY Arcangelo Russo, MD, ITALY Mirco Lo Presti, MD, ITALY Iacopo Sassoli, MD, ITALY Matteo La Verde, MD, ITALY Giulio Maria Marcheggiani Muccioli, MD, PhD, Associate Professor, ITALY
Factors Associated With Failure and Survivorship Following Unicompartmental Knee Arthroplasty: A Single-Center Experience ePoster Presentation Anirudh K Gowd, MD, UNITED STATES Johannes F. Plate, MD, PhD, UNITED STATES Asher Lichtig, MD, UNITED STATES Orhan Yanmis, MD, UNITED STATES Gary G. Poehling, MD, UNITED STATES
Comparison of Outcomes between Fungal and Non-fungal Periprosthetic Joint Infections in Total Knee Arthroplasty: A Propensity Score-Matched Analysis ePoster Presentation Hong Yeol Yang, MD, PhD, KOREA, REPUBLIC OF Jong-Keun Seon, MD, PhD, Prof, KOREA, REPUBLIC OF
Clinical Comparison and Survival Rate Between Unicompartmental Knee Arthroplasty and High Tibial Osteotomy With An External Fixator For Varus Knee In Patients Younger Than 60 Years at Mid-Term Follow-Up ePoster Presentation Amit Kumar Yadav, M.S (Orth),DNB(Orth),MNAMS, UNITED KINGDOM Riccardo D'Ambrosi, MD, ITALY Mangal Parihar, MS Ortho, INDIA
Association Between The Femoral And Tibial Component Positions and Intraoperative Knee Kinematics In Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Relationship Between The Femoral And Tibial Component Positions And Postoperative Knee Range Of Motion After Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Tibia Placement Difference Between The Supine And Prone Position After Total Knee Arthroplasty: The Comparison Of The BCS and PS-TKA ePoster Presentation Takanori Iriuchishima, MD, PhD, JAPAN Keinosuke Ryu, Prof., JAPAN Eiji Cho, MD, JAPAN
Calipered Measurements Method For Kinematically Aligned Total Knee Arthroplasty Has A Risk Of Excessive Varus Cut For The Proximal Tibia In Japanese Varus Knees ePoster Presentation Umit Kuwa, MD, PhD, JAPAN Masafumi Itoh, MD, PhD, JAPAN Junya Itou, MD, PhD, JAPAN Ken Okazaki, MD, PhD, JAPAN
Antibiotic-Loaded Bone Cement with Colistin at Erythromycin Do Not Decrease Chronic TKA Pji at a Long-Term ePoster Presentation Daniel Pérez-Prieto, MD, SPAIN Albert Fontanellas, MD, SPAIN Pedro Hinarejos, MD, PhD, SPAIN Juan Francisco Sanchez-Soler, MD, PhD, SPAIN Raúl Torres-Claramunt, PhD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Anatomical distribution of radiological OA Influences the Outcome of TKA ePoster Presentation Johanna Elliott, MB, BS, B.Med Sci, Master Science, GERMANY

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Influence of Mini Approach Instrumentation on Component Alignment In Unicondylar Knee Replacement

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