A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment
Abstract Background The mobile Oxford unicompartmental knee arthroplasty (UKA) implant has been widely used with an intramedullary guide for femoral preparation. We modified the femoral guide technique based on the tibial cut first and spacer block technique. This study was performed to determine th...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-03-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01598-6 |
| _version_ | 1811185156205051904 |
|---|---|
| author | Qidong Zhang Weiguo Wang Zhaohui Liu Debo Yue Liming Cheng Bailiang Wang Wanshou Guo |
| author_facet | Qidong Zhang Weiguo Wang Zhaohui Liu Debo Yue Liming Cheng Bailiang Wang Wanshou Guo |
| author_sort | Qidong Zhang |
| collection | DOAJ |
| description | Abstract Background The mobile Oxford unicompartmental knee arthroplasty (UKA) implant has been widely used with an intramedullary guide for femoral preparation. We modified the femoral guide technique based on the tibial cut first and spacer block technique. This study was performed to determine the radiographic accuracy and early clinical outcomes of the extramedullary method. Methods We retrospectively evaluated 50 consecutive patients who underwent UKA using the extramedullary technique. An equal number of patients who underwent UKA with the conventional technique were matched as the control group. Clinical outcomes were evaluated in terms of the operating time, blood loss, range of motion, and Hospital for Special Surgery score. Radiographic accuracy was evaluated by the implant position and alignment in the coronal and sagittal planes. Results The mean follow-up period was 39.76 ± 5.77 months. There were no differences in the postoperative Hospital for Special Surgery score, range of motion, or hip-knee-ankle angle between the two groups. The operating time in the extramedullary group was shorter than that in the conventional group (54.78 ± 7.95 vs. 59.14 ± 10.91 min, respectively; p = 0.025). The drop in hemoglobin after 3 days was only 12.34 ± 4.98 g/L in the extramedullary group which was less than that in the conventional group (p = 0.001). No significant differences were found in the postoperative coronal and sagittal angles between the two groups. Acceptable radiographic accuracy of the implant alignment and position was achieved in 92% of patients in the extramedullary group and 96% of patients in the conventional group. Conclusions The radiographic and clinical results of the extramedullary technique were comparable with those of the conventional technique with the advantage of no intramedullary interruption, less blood loss, a shorter operating time, and more rapid recovery. As the technique depends on the accurate tibial cut and overall alignment, we do not recommend it to surgeons without high volume experiences. Trial registration Retrospectively registered Level of evidence IV, retrospective study |
| first_indexed | 2024-04-11T13:25:42Z |
| format | Article |
| id | doaj.art-75e90b51c785441aa6a51856d2571eb8 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:25:42Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-75e90b51c785441aa6a51856d2571eb82022-12-22T04:22:05ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-03-011511910.1186/s13018-020-01598-6A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignmentQidong Zhang0Weiguo Wang1Zhaohui Liu2Debo Yue3Liming Cheng4Bailiang Wang5Wanshou Guo6Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Peking Union Medical CollegeDepartment of Orthopaedic Surgery, China-Japan Friendship Hospital, Peking Union Medical CollegeDepartment of Orthopaedic Surgery, China-Japan Friendship Hospital, Peking Union Medical CollegeDepartment of Orthopaedic Surgery, China-Japan Friendship Hospital, Peking Union Medical CollegeDepartment of Orthopaedic Surgery, China-Japan Friendship Hospital, Peking Union Medical CollegeDepartment of Orthopaedic Surgery, China-Japan Friendship Hospital, Peking Union Medical CollegeDepartment of Orthopaedic Surgery, China-Japan Friendship Hospital, Peking Union Medical CollegeAbstract Background The mobile Oxford unicompartmental knee arthroplasty (UKA) implant has been widely used with an intramedullary guide for femoral preparation. We modified the femoral guide technique based on the tibial cut first and spacer block technique. This study was performed to determine the radiographic accuracy and early clinical outcomes of the extramedullary method. Methods We retrospectively evaluated 50 consecutive patients who underwent UKA using the extramedullary technique. An equal number of patients who underwent UKA with the conventional technique were matched as the control group. Clinical outcomes were evaluated in terms of the operating time, blood loss, range of motion, and Hospital for Special Surgery score. Radiographic accuracy was evaluated by the implant position and alignment in the coronal and sagittal planes. Results The mean follow-up period was 39.76 ± 5.77 months. There were no differences in the postoperative Hospital for Special Surgery score, range of motion, or hip-knee-ankle angle between the two groups. The operating time in the extramedullary group was shorter than that in the conventional group (54.78 ± 7.95 vs. 59.14 ± 10.91 min, respectively; p = 0.025). The drop in hemoglobin after 3 days was only 12.34 ± 4.98 g/L in the extramedullary group which was less than that in the conventional group (p = 0.001). No significant differences were found in the postoperative coronal and sagittal angles between the two groups. Acceptable radiographic accuracy of the implant alignment and position was achieved in 92% of patients in the extramedullary group and 96% of patients in the conventional group. Conclusions The radiographic and clinical results of the extramedullary technique were comparable with those of the conventional technique with the advantage of no intramedullary interruption, less blood loss, a shorter operating time, and more rapid recovery. As the technique depends on the accurate tibial cut and overall alignment, we do not recommend it to surgeons without high volume experiences. Trial registration Retrospectively registered Level of evidence IV, retrospective studyhttp://link.springer.com/article/10.1186/s13018-020-01598-6Unicompartmental knee arthroplastySurgical techniqueExtramedullaryRadiologicClinical outcome |
| spellingShingle | Qidong Zhang Weiguo Wang Zhaohui Liu Debo Yue Liming Cheng Bailiang Wang Wanshou Guo A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment Journal of Orthopaedic Surgery and Research Unicompartmental knee arthroplasty Surgical technique Extramedullary Radiologic Clinical outcome |
| title | A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment |
| title_full | A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment |
| title_fullStr | A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment |
| title_full_unstemmed | A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment |
| title_short | A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment |
| title_sort | novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment |
| topic | Unicompartmental knee arthroplasty Surgical technique Extramedullary Radiologic Clinical outcome |
| url | http://link.springer.com/article/10.1186/s13018-020-01598-6 |
| work_keys_str_mv | AT qidongzhang anovelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT weiguowang anovelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT zhaohuiliu anovelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT deboyue anovelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT limingcheng anovelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT bailiangwang anovelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT wanshouguo anovelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT qidongzhang novelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT weiguowang novelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT zhaohuiliu novelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT deboyue novelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT limingcheng novelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT bailiangwang novelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment AT wanshouguo novelextramedullarytechniquetoguidefemoralbonepreparationinmobileunicompartmentalkneearthroplastybasedontibialcutandoverallalignment |