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CASE 3 GRADE III MEDIAL OA IN ACTIVE 55 YRS OLD MAN UKA Oliver Kessler Zurich, Switzerland Surgical treatment options for medial compartment osteoarthritis of the knee include total knee arthroplastey (TKA) or unicompartmental knee arthroplasty (UKA), depending on the patient's age, level of physical activity and the degree of deformity. Following arthroplasty of the knee, the patient's perception of improvement in symptoms is fundamental to the assessment of outcome. The rate of excellent and good outcome are similar in TKA group. In UKA group, the patients have lesser blood loss and a faster recovery. UKA is more minimally invasive and protects the soft tissue in a higher degree than TKA. Total knee arthroplasty has been extremely successful in elderly patients with osteoarthritis. However, there is considerable controversy regarding how best to treat patient with advanced arthritis. In the younger patient group, UKA compared to TKA allow them to maintain an active, healthy lifestyle. Preserving both cruciate ligaments in unicondylar knee arthroplasty likely provides more normal knee mechanics and contributes to enhanced patient function. Preserving both cruciate ligaments UKA maintain some basic features of normal knee kinematics. A disadvantage of TKA is the arduous rehabilitation and bone loss, opting for UKA, especially in young, high-demand patients. TKA procedures demonstrate more problems with the patella in regards of anterior knee pain. In TKA it’s still an unsolved poroblem wether to replace the patella or not. UKA treated patients show less problems with patella compared to TKA treated patients. References 1. Berger, R. A. et al. Unicompartmental knee arthroplasty. Clinical experience at 6- to 10-year followup. Clin.Orthop.Relat Res.367 (1999): 50-60 2. Deshmukh R V and Scott R D: Unicompartmental knee arthroplasty: long-term results. Clin. Orthop.Relat Res. 392 (2001): 272-78 3. Faour-Martín O et al.Oxford phase 3 unicondylar knee arthroplasty through a minimally invasive approach: long-term results. Int Orthop. 2013 Mar 17 4. Baker PN et al.Comparison of patient-reported outcome measures following total and unicondylar knee replacement. Bone Joint Surg Br. 2012 Jul;94(7):919-27. 22
CASE 4 OSTEOARTHRITIS GRAD III LATERAL COMPARTMENT History: O/E: - 60 yrs. old lady - BMI 35kg/cm2 - Pensioner - Daily pain - No sports activities - Mild Effusion - Full ROM - Collateral ligaments stabile - Pain at the lateral side and at the patellofemoral compartment 23
Page 1 and 2: The Osteoarthritic Knee Best Curren
Page 3 and 4: Patellofemoral + medial OA in a 60
Page 5 and 6: SESSION 8 INFECTION Chairmen: S. Ho
Page 7 and 8: LOAD ABSORPTION - A SOLUTION TO DEL
Page 9 and 10: THE ROLE OF HIGH TIBIAL OSTEOTOMY P
Page 11 and 12: PATIENTS EXPECTATIONS AND OUTCOME A
Page 13 and 14: CASE 1 OSTEOARTHRITIS GRAD II MEDIA
Page 15 and 16: CASE 1 GRADE II OA NEUTRAL ALIGNMEN
Page 17 and 18: CASE 2 GRADE II MEDIAL OA IN ACTIVE
Page 19: CASE 3 OSTEOARTHRITIS GRAD III MEDI
Page 24 and 25: CASE 4 GRADE III LATERAL OA IN ACTI
Page 26 and 27: CASE 5 PATELLOFEMORAL + MEDIAL OSTE
Page 28 and 29: CASE 5 PATELLOFEMORAL + MEDIAL OA I
Page 30 and 31: PLANNING + APPROACH Roland Becker D
Page 32 and 33: BONE CUTS +ROTATIONAL POSITION Norb
Page 34 and 35: SOFT TISSUE BALANCING + PATELLAR TR
Page 36 and 37: BLOOD MANAGEMENT + PAIN CONTROL & R
Page 38 and 39: WHO WILL PAY THE COSTS OF NEW TECHN
Page 40 and 41: HOW TO IMPROVE PATELLO-FEMORAL TRAC
Page 42 and 43: placement (in flexion and posterior
Page 44 and 45: PLANNING WITH CONVENTIONAL X-RAY OR
Page 46 and 47: MULTIMODAL APPROACHES FOR A SHORTER
Page 48 and 49: STAYING OUT OF TROUBLE AT PRIMARY T
Page 50 and 51: GAP BALANCING TECHNIQUE AND STABILI
Page 52 and 53: “ADAPTED” MEASURED RESECTION TE
Page 54 and 55: PATELLAR RESURFACING TECHNICAL TIPS
Page 56 and 57: TKA IN POST-TRAUMATIC OSTEOARTHRITI
Page 58 and 59: TKA IN THE STIFF KNEE Michel Bonnin
Page 60 and 61: HOW DO I MANAGE SEVERELY DEFORMED K
Page 62 and 63: which will create easier extension
Page 64 and 65: PLANNING AND CORRECTION OF EXTRA-AR
Page 66 and 67: Fig. 2. Case number 10, a 74-year-o
Page 68 and 69: INFECTION DIAGNOSIS - A EUROPEAN PE
Page 70 and 71: MANAGEMENT EARLY WOUND HEALING COMP
Page 72 and 73:
DEBRIDEMENT AND POLYETHYLENE LINER
Page 74 and 75:
4. Barrack RL, Engh G, Rorabeck C,
Page 76 and 77:
FAILURE ANALYSIS AND PATIENT SELECT
Page 78 and 79:
APPROACH / IMPLANT REMOVAL + 3 STEP
Page 80 and 81:
References 1. Meneghini RM, Lewalle
Page 82 and 83:
LEVEL OF CONSTRAINT + EXTENSOR MECH
Page 84 and 85:
WHICH IS THE BEST STEM EXTENSION FO
Page 86 and 87:
WHICH IS THE BEST STEM EXTENSION FO
Page 88 and 89:
FILLING THE DEFECT. METAPHYSEAL SOL
Page 90 and 91:
THE BEST SPACER FOR THE INFECTED TK
Page 92 and 93:
EXPOSURE FOR REVISION TKA: HOW DO Y
Page 94 and 95:
USE OF HINGES IN REVISION TOTAL KNE
Page 96 and 97:
References 1. Lachiewicz PF. Tantal
Page 98 and 99:
DIAPHYSEAL PREPARATION AND FIXATION
Page 100 and 101:
HOW TO TREAT A DAMAGED PATELLA DURI
Page 102 and 103:
REVISION TKA WITH ASSOCIATED EXTRA-
Page 104:
CASE - BILATERAL INFECTED TKA: EVAL
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