Unicompartmental Arthroplasty - PowerPoint PPT Presentation

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Unicompartmental Arthroplasty

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Average penetration rate 0.03mm per year. Average time for ... Quicker Flexion. Time to recovery: 3x faster than TKR (p 0.001) 2x faster than open UKR (p 0.001) ... – PowerPoint PPT presentation

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Title: Unicompartmental Arthroplasty


1
Unicompartmental Arthroplasty
  • John Goodfellow
  • Nuffield Orthopaedic
  • Centre, Oxford

2
AnteromedialOsteoarthritis(30 of OA knees)
3
Fixed Bearing UKR
  • Wear inescapable Incongruous
  • Thin polyethylene
  • Catastrophic failure

4
Meniscal function
5
Phase 1 1976
6
Polyethylene Wear
  • Average penetration rate 0.03mm per year
  • Average time for 1mm penetration 33 years

10 year retrieval
7
Indications
  • Not Contraindications
  • Patello-femoral joint
  • Chondrocalcinosis
  • Obesity
  • Age
  • Activity
  • Criteria
  • Antero-medial OA
  • Intact ACL
  • Full thickness lateral
  • Correctable varus
  • FFD less than 15
  • 1 in 3 OA knees

8
UKR - Designers series
  • 10 year survival 98
  • Murray et al JBJS 1998

9
Svard Price (AAOS 2006)
20 yr survival 92 CI 15.1 10 yr 90 Good or
Excellent HSS (n187)
10
Minimally Invasive Surgery
11
MIS results Early Recovery
  • Less Bleeding
  • Lower Morbidity
  • Shorter Hospital Stay
  • Quicker Flexion
  • Time to recovery
  • 3x faster than TKR (plt0.001)
  • 2x faster than open UKR (plt0.001)

12
National Registers
  • Measured by revision, failure rate of UKR at
    10yrs is approx x 2 TKR
  • National failure rates of UKR are higher than
    reports from Specialist Centres
  • Failure rates of UKR vary with the experience of
    the surgeon

13
Dependence on Surgical Experience(Roberttson et
al)
14
Instructional Courses
  • To diminish the learning curve
  • To teach indications
  • To improve surgical technique
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