Bi-unicompartmental knee protheses

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.