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Online ISSN 1827-1707
L’ARTO INFERIORE: UN AGGIORNAMENTO
Benazzo F., Rossi S. M. P., Ghiara M.
Clinic of Orthopedics and Traumatology University of Pavia, Fondazione IRCCS Policlinico San Matteo Pavia, Italy
Unicompartmental knee arthroplasty (UKA) has evolved significantly over the last decades. The advantages of this surgical option over total knee arthroplasty (TKA) are lower perioperative morbidity and earlier recovery, in keeping with the concept of mini-invasive surgery in terms of skin incision and bone resection and ligament retention. Clinical outcome and kinematic studies have suggested that, by virtue of ligament retention, successful UKA provides joint functions more closely resembling those of a normal knee. The indications for UKA have therefore been extended to include younger and heavier patients. Good results at follow-up after implantation of measured resection and resurfacing prostheses have been such that both fixed- and mobile-bearing implants can yield excellent clinical outcomes at >10 years but with different modes of long-term failure. Correct preoperative indication and proper execution of surgical technique remain critical to optimizing outcome and to minimize the risk of early or late implant failure. Revision surgery should not be considered standard TKA because the surgeon has to understand the cause of failure so as to prevent excessive bone resection and, when indicated, to implant greater constraint TKA with augmentation in the site of the unicompartmental tibial plateau.