Fixed-bearing medial partial knee replacement: patient selection and surgical technique - 08/02/21

Doi : 10.1016/j.mporth.2020.12.005

Nick J. London, James B. Newman, Dave J. Duffy, Jon Smith
Nick J London MBBChir MAMD (Cantab.) FRCS (Tr & Orth), Consultant Knee Surgeon, Harrogate District Foundation Trust and Yorkshire Knee Clinic, UK. Visiting Professor of Sports Medicine, Leeds Beckett University, UK. Conflicts of interest: In the last 5 years, one or more of the authors has received consultancy fees and/or royalties from a company that produces both partial and total knee implants
James B Newman MBChB FRCS (Tr & Orth), Consultant Knee Surgeon, The Mid Yorkshire Hospitals NHS Trust and Yorkshire Knee Clinic, UK. Conflicts of interest: In the last 5 years, one or more of the authors has received consultancy fees and/or royalties from a company that produces both partial and total knee implants
Dave J Duffy MBBS FRCS (Tr & Orth), Consultant Knee Surgeon, Harrogate District Foundation Trust and Yorkshire Knee Clinic, UK. Conflicts of interest: In the last 5 years, one or more of the authors has received consultancy fees and/or royalties from a company that produces both partial and total knee implants
Jon Smith MBChB (Hons) FRCS (Tr &Orth), Consultant Knee Surgeon, The Mid Yorkshire Hospitals NHS Trust and Yorkshire Knee Clinic, UK. Conflicts of interest: In the last 5 years, one or more of the authors has received consultancy fees and/or royalties from a company that produces both partial and total knee implants

Abstract

Partial knee replacement (PKR) surgery has become the treatment of choice for patients with isolated medial or lateral compartment osteoarthritis with less surgical risk, more favourable functional outcomes and revision rates approaching those of total knee replacement (TKR) in experienced hands. Patient selection remains a concern for many surgeons and training opportunities are unfortunately less common for PKR than TKR. This review from four, highly experienced, partial knee surgeons seeks to clarify selection criteria and offers a simple reproducible surgical technique for fixed-bearing medial partial knee replacement.

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Keywords : fixed-bearing, partial knee replacement, patient selection, surgical technique, unicompartmental knee surgery

Plan

Introduction

Patient selection for fixed-bearing partial knee replacement

General indications

Age and functional demand

Deformity

Site of pain

Body mass index (BMI)

Anterior knee pain (patellofemoral OA)

Anterior cruciate ligament (ACL) deficiency

Shared decision-making

Surgical technique/tips for successful medial PKR

Five key principles of medial fixed-bearing PKR surgical technique

Spacer block surgical technique for the varus knee

Patient set-up

Incision and exposure

Initial tibial resection

Tibial cut technique

Conclusion

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Vol 35 - N° 1

P. 39-48 - février 2021 Retour au numéro

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Fixed-bearing medial partial knee replacement: patient selection and surgical technique - 08/02/21

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