von Knoch F, Munzinger U
Gelenkzentrum Zürich, Toblerstr. 51, 8044, Zürich, Schweiz,
Orthopade. 2014 May;43(5):414-24. doi: 10.1007/s00132-013-2188-8.
Unicondylar knee arthroplasty (UKA) is an established therapeutic option for advanced medial or lateral gonarthrosis.
The cornerstones of a successful UKA, careful patient selection, preoperative planning and precise operation technique, are discussed in this overview article.
In contrast to total knee arthroplasty, UKA allows preservation of the contralateral and patellofemoral compartments as well as the cruciate ligaments and is often associated with rapid postoperative recovery, improved knee kinematics and knee function. However, UKA is technically very demanding. High revision rates have been reported in particular with widespread application, according to national joint replacement registries.
Successful UKA relies on meticulous patient selection, preoperative planning and surgical technique. It is justified to broaden classic UKA indications. In medial and lateral UKA three types of mechanical varus-valgus deformity can be encountered: type 1 (isolated intraarticular deformity), type 2 (pronounced deformity due to extraarticular varus deformity in medial UKA or valgus deformity in lateral UKA), type 3 (reduced deformity due to extraarticular valgus deformity in medial UKA or varus deformity in lateral UKA). We believe these deformities should be addressed accordingly with surgical technique.
单髁膝关节置换术(UKA)是晚期内侧或外侧膝关节骨关节炎的一种既定治疗选择。
在这篇综述文章中讨论了成功进行UKA的基石,即仔细的患者选择、术前规划和精确的手术技术。
与全膝关节置换术不同,UKA能够保留对侧和髌股关节腔以及交叉韧带,并且通常与术后快速恢复、改善膝关节运动学和膝关节功能相关。然而,UKA在技术上要求很高。根据国家关节置换登记处的数据,特别是随着广泛应用,已报告了较高的翻修率。
成功的UKA依赖于细致的患者选择、术前规划和手术技术。扩大经典UKA的适应症是合理的。在内侧和外侧UKA中,可遇到三种类型的机械性内翻-外翻畸形:1型(孤立的关节内畸形)、2型(内侧UKA中由于关节外内翻畸形或外侧UKA中外翻畸形导致的明显畸形)、3型(内侧UKA中由于关节外外翻畸形或外侧UKA中内翻畸形导致的减轻畸形)。我们认为这些畸形应通过手术技术相应地加以处理。