[Minimally invasive implantation of a unicondylar knee system].
OBJECTIVE
Unicondylar medial surface replacement of the knee joint by arthrotomy with short incision and in bone-sparing resection technique.


METHODS
Unicompartmental medial arthritis of the joint knee. Unilateral osteonecrosis. Posttraumatic unicompartmental gonarthrosis.


METHODS
Pangonarthrosis. Rheumatoid arthritis. Knee joint instability. Status following osteotomy of the tibial head.


METHODS
The patient should be placed in the supine position with the knee joint uncovered and freely mobile. Short anteromedial skin incision and arthrotomy. Bone-sparing resection at the tibia and femur. Axial malalignment (varus deformity) is not completely corrected. The implants are centered perpendicular to one another.


METHODS
Early functional postoperative management adapted to the symptoms with pain therapy, local application of ice, passive mobilization on an electric exercise splint and physiotherapy. Full weight bearing is usually possible from the 2nd postoperative day.


RESULTS
28 Accuris unicondylar knee systems were implanted medially in 26 patients (14 women, twelve men) in minimally invasive technique from March 2003 to July 2004. One patient was not included in the evaluation because the operation was changed to a bicondylar surface replacement due to a deep-seated infection. The patients' average age at the time of the operation was 73.8 years. On average, the operation scar was 8.2 cm long. The average quantity of secretion in the Redon drain was 155 ml. The hemoglobin value fell from 13.3 to 12.3 g/dl. The total HSS (Hospital for Special Surgery) Score increased significantly from 55.5 (34-75) to 87.4 (71-95) points. In the follow-up examination, 21 unicondylar knee systems (77.8%) were evaluated as excellent and six (22.2%) as good.
Buckup
Klaus
K
Orthopädische Klinik, Klinikum Dortmund gGmbH, Akademisches Lehrkrankenhaus der Universität Münster, Beurhausstrasse 40, D-44137 Dortmund. klaus@buckup.de
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D001843:Bone Cements / Q000627:therapeutic use*; D002484:Cementation / Q000379:methods; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods*
D001843:Bone Cements