Abstract
One of the most evolving fields in orthopedics is knee replacement surgery. The ultimate goal is to let the patients have the same function, activity level, and feedback of a normal knee. To obtain them, research focuses in developing more anatomical components and in a closest reproduction of native biomechanics; surgical techniques develop to obtain a limited invasiveness and the respect of the unaffected elements of the joint (tissue-sparing surgery). In particular, the maintaining of the anterior cruciate ligament and the obtaining of an anatomical coronal alignment result in a knee kinematic closer to the normal one. Unicompartmental knee arthroplasty (UKA) has already showed excellent clinical results and survivorship in large series of patients. The benefits of UKA could be obtained even in bicompartmental osteoarthritis, when both the tibiofemoral compartments or one tibiofemoral and the patellofemoral one are involved. In these cases, the implant of a bi-UKA or a UKA+patellofemoral arthroplasty with an anatomical alignment permits a close restoration of knee kinematic with high functional results. Moreover, the use of small implants and the tissue-sparing philosophy permits a very limited bone loss and a reduced damage of muscular and capsular tissues, allowing for a faster recovery compared to total knee replacement.
Similar content being viewed by others
References
Flecher X, Parratte S, Aubaniac JM, Argenson JN. A 12–28-year follow-up study of closing wedge high tibial osteotomy. Clin Orthop Relat Res. 2006;452:91–6.
Pagnano MW, Clarke HD, Jacofsky DJ, Amendola A, Repicci JA. Surgical treatment of the middle-aged patient with arthritic knees. Instr Course Lect. 2005;54:251–9.
Naudie D, Bourne RB, Rorabeck CH, Bourne TJ. The install award. Survivorship of the high tibial valgus osteotomy. A 10- to 22-year follow-up study. Clin Orthop Relat Res. 1999;367:18–27.
Schallberger A, Jacobi M, Wahl P. High tibial valgus osteotomy in unicompartmental medial osteoarthritis of the knee: a retrospective follow-up study over 13–21 years. Knee Surg Sports Traumatol Arthrosc. 2011;19:122–7.
Papachristou G, Plessas S, Sourlas J, Levidiotis C, Chronopoulos E, Papachristou C. Deterioration of long-term results following high tibial osteotomy in patients under 60 years of age. Int Orthop. 2006;30:403–8.
Ritter MA, Berend ME, Meding JB, Keating EM, Faris PM, Crites BM. Long-term follow-up of anatomic graduated components posterior cruciate-retaining total knee replacement. Clin Orthop Relat Res. 2001;388:51–7.
Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop. 2008;79:499–507.
Kim YH, Park JW, Kim JS, Kulkarni SS, Kim YH. Long-term clinical outcomes and survivorship of press-fit condylar sigma fixed-bearing and mobile-bearing total knee prostheses in the same patients. J Bone Joint Surg Am. 2014;96(19):e168.
Laurencin CT, Zelicof SB, Scott RD, Ewald FC. Unicompartmental versus total knee arthroplasty in the same patient. A comparative study. Clin Orthop Relat Res. 1991;273:151–6.
Brown NM, Sheth NP, Davis K, Berend ME, Lombardi AV, Berend KR, Della Valle CJ. Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J Arthroplasty. 2012;27(8 Suppl):86–90. doi:10.1016/j.arth.2012.03.022.
Berger RA, Meneghini RM, Jacobs JJ, Sheinkop MB, Della Valle CJ, Rosenberg AG, Galante JO. Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. J Bone Joint Surg Am. 2005;87(5):999–1006.
Johnson AJ, Howell SM, Costa CR, Mont MA. The ACL in the arthritic knee: how often is it present and can preoperative tests predict its presence? Clin Orthop Relat Res. 2013;471(1):181–8. doi:10.1007/s11999-012-2505-2.
Gunston FH. Polycentric knee arthroplasty. Prosthetic simulation of normal knee movement. J Bone Joint Surg Br. 1971;53(2):272–7.
Marmor L. The modular knee. Clin Orthop Relat Res. 1973;94:242–8.
Coventry MB. Two-part knee arthroplasty: evolution and present status. Clin Orthop. 1979;145:29–36.
Bellemans J. Bicruciate-substituting and bicruciate-replacing arthroplasty of the knee: technique and results. In: Scuderi GR, Tria Jr AJ, editors. The knee: a comprehensive review. Hackensack: World Scientific; 2010.
Buechel FF, Pappas MJ. Long-term survivorship analysis of cruciate-sparing versus cruciate-sacrificing knee prostheses using meniscal bearings. Clin Orthop Relat Res. 1990;260:162–9.
Yoshioka Y, Siu D, Cooke TD. The anatomy and functional axes of the femur. J Bone Joint Surg Am. 1987;69(6):873–80.
Moreland JR, Bassett LW, Hanker GJ. Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am. 1987;69(5):745–9.
Paley D. Principles of deformity correction. Berlin: Springer; 2002.
Bellemans J, Colyn W, Vandenneucker H, Victor J. The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus. Clin Orthop Relat Res. 2012;470:45–53.
Baker PN, van der Meulen JH, Lewsey J, Gregg PJ. The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J Bone Joint Surg (Br). 2007;89-B:893–900. doi:10.1302/0301-620X.89B7.19091.
Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop. 2010;468:57–63. doi:10.1007/s11999-009-1119-9.
Romagnoli S, Verde F. L’allineamento coronale nelle protesi totali di ginocchio. Lo Scalpello. 2013;27:126–31. doi:10.1007/s11639-013-0036-6.
Romagnoli S, Verde F, Corbella M, Zacchetti S. The bi-unicompartmental knee prosthesis. In: Confalonieri N, Romagnoli S, editors. Small implants in knee reconstructions. Milan: Springer; 2013. p. 81–93.
Romagnoli S, Verde F. Le bimono con ricostruzione dell’LCA nel 50 enne. Acta Orthop Ital. 2011;1:115–22.
Romagnoli S, Marullo M, Massaro M, Rustemi E, D’Amario F, Corbella M. Bi-unicompartmental and combined uni plus patellofemoral replacement: indications and surgical technique. Joints. 2015;3(1):42–8.
Romagnoli S, Verde F, Corbella M, Zacchetti S. Bicompartmental prosthesis. In: Confalonieri N, Romagnoli S, editors. Small implants in knee reconstructions. Milan: Springer; 2013. p. 105–16.
Romagnoli S, Verde F, Bibbiani E. Protesi femoro-rotulea isolate e mono + FR. Minerva Ortop Traumatol. 2008;59 Suppl 1:5.
Argenson JN, Komistek RD, Aubaniac JM, Dennis DA, Northcut EJ, Anderson DT, Agostini S. In vivo determination of knee kinematics for subjects implanted with a unicompartmental arthroplasty. J Arthroplasty. 2002;17:1049–54.
Heyse TJ, El-Zayat BF, De Corte R, Scheys L, Chevalier Y, Fuchs-Winkelmann S, Labey L. Biomechanics of medial unicondylar in combination with patellofemoral knee arthroplasty. Knee. 2014;21 Suppl 1:S3–9. doi:10.1016/S0968-0160(14)50002-6.
Wünschel M, Lo J, Dilger T. Influence of bi-and tri-compartmental knee arthroplasty on the kinematics of the knee joint. BMC Musculoskelet Disord. 2011;12:29. doi:10.1186/1471-2474-12-29. 27.
Banks SA, Fregly BJ, Boniforti F, Reinschmidt C, Romagnoli S. Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacement. Knee Surg Sports Traumatol Arthrosc. 2005;13(7):551–6.
Perry J, Burnfield JM. Gait analysis: normal and pathological function. 2nd ed. Thorofare: SLACK Incorporated; 2010.
Komnik I, Weiss S, Fantini Pagani CH, Potthast W. Motion analysis of patients after knee arthroplasty during activities of daily living. A systematic review. Gait Posture. 2015;41(2):370–7. doi:10.1016/j.gaitpost.2015.01.019..
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this entry
Cite this entry
Romagnoli, S., Marullo, M., Stucovitz, E., Verde, F., Corbella, M. (2015). Bi-unicompartmental Knee Protheses. In: Scuderi, G., Tria, A. (eds) Minimally Invasive Surgery in Orthopedics. Springer, Cham. https://doi.org/10.1007/978-3-319-15206-6_57-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-15206-6_57-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Online ISBN: 978-3-319-15206-6
eBook Packages: Springer Reference MedicineReference Module Medicine