Predicting the Feasibility of Correcting Mechanical Axis in Large Varus Deformities With Unicompartmental Knee Arthroplasty

The Journal of Arthroplasty
Laura J KleebladS Robert Rozbruch

Abstract

Due to disappointing historical outcomes of unicompartmental knee arthroplasty (UKA), Kozinn and Scott proposed strict selection criteria, including preoperative varus alignment of ≤15°, to improve the outcomes of UKA. No studies to date, however, have assessed the feasibility of correcting large preoperative varus deformities with UKA surgery. The study goals were therefore to (1) assess to what extent patients with large varus deformities could be corrected and (2) determine radiographic parameters to predict sufficient correction. In 200 consecutive robotic-arm assisted medial UKA patients with large preoperative varus deformities (≥7°), the mechanical axis angle (MAA) and joint line convergence angle (JLCA) were measured on hip-knee-ankle radiographs. It was assessed what number of patients were corrected to optimal (≤4°) and acceptable (5°-7°) alignment, and whether the feasibility of this correction could be predicted using an estimated MAA (eMAA, preoperative MAA-JLCA) using regression analyses. Mean preoperative MAA was 10° of varus (range, 7°-18°), JLCA was 5° (1°-12°), postoperative MAA was 4° of varus (-3° to 8°), and correction was 6° (1°-14°). Postoperative optimal alignment was achieved in 62% and acceptable align...Continue Reading

Citations

Aug 2, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Cécile BataillerSébastien Lustig
Feb 8, 2019·The Journal of Bone and Joint Surgery. American Volume·J A KennedyD W Murray
Sep 9, 2020·The Journal of Knee Surgery·Christopher N CarenderTimothy S Brown
Mar 19, 2021·JBJS Reviews·Sravya P VajapeyDouglas J Chonko
Dec 19, 2021·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Abhishek KumarHorng-Chaung Hsu
Jan 18, 2022·Archives of Orthopaedic and Trauma Surgery·Georg MatziolisNadja Jacob

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