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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How to Measure Physical Function in Clinical Trials on Patients Undergoing Total or Partial Knee Arthroplasty? A Systematic Review ePoster Presentation Marco Adriani, MD, ITALY Roland Becker, MD, PhD, Prof., GERMANY Aleksandra Krolikowska, PhD, Prof., POLAND Krzysztof Lachowski, MD, GERMANY Robert Prill, PhD, GERMANY
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
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
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
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
Patellar Medial-lateral Position can be Used to Correct the Effect of Leg Rotation on Preoperative Planning in Total Knee Arthroplasty for Varus Knees ePoster Presentation Shinichiro Nakamura, MD, PhD, JAPAN Shota Takemoto, MD, JAPAN Shinichi Kuriyama, MD, PhD, JAPAN Kohei Nishitani, MD, PhD, JAPAN Hiromu Ito, MD, PhD, JAPAN Mutsumi Watanabe, MD, PhD, JAPAN Young Dong Song, MD, PhD, UNITED STATES Shuichi Matsuda, MD, PhD, JAPAN
Total Knee Arthroplasty Outcomes Following Anterior Cruciate Ligament Reconstruction ePoster Presentation Brian Rao, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Eric Milliron, BS, UNITED STATES Parker Cavendish, BS, UNITED STATES James C. Kirven, BS, UNITED STATES Spencer E. Talentino, MD, UNITED STATES Charles Qin, MD, UNITED STATES Ryan H. Barnes, MD, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES Robert A Magnussen, MD, MPH, UNITED STATES David C. Flanigan, MD, UNITED STATES
Detection Loosening of Total Knee Arthroplasty Implant from Plain Radiograph Using Machine Learning Algorithm ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Combined Single-Shot Infiltration Between the Popliteal Artery and Capsule of the Knee and Adductor Canal Block with Bupivacaine, Dexmedetomidine, and Dexamethasone for Total Knee Arthroplasty: A Propensity-Matched Analysis ePoster Presentation David Freccero, MD, UNITED STATES Aneesh V Samineni, BA, UNITED STATES Seroos Salavati, MD, UNITED STATES
Advanced Active Robotic Technology for Total Knee Arthroplasty: A Learning Curve of Operative Time and Alignment Accuracy ePoster Presentation Yong-Beom Park, MD, PhD, KOREA, REPUBLIC OF Young-Bong Ko, MD, KOREA, REPUBLIC OF Dong-Hoon Lee, MD, KOREA, REPUBLIC OF Hyun-Chul Nam, MD, KOREA, REPUBLIC OF Seong-Hwan Kim, MD,Ph.D, MStat, KOREA, REPUBLIC OF

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

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

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