[Fixed bearing unicondylar arthroplasty in medial osteoarthritis of the knee].
OBJECTIVE
The unicondylar prosthesis replaces the medial femerotibial compartment only, the part presenting with osteoarthritic changes. The remaining compartments of the knee present less osteoarthritic changes and thus can be preserved.


METHODS
Osteoarthritis of the medial femorotibial compartment is the ideal indication for unicondylar arthroplasty. The knee should show an intraarticular deformity, which means the malalignment is caused by the osteoarthritic changes of the medial compartment.


METHODS
Malalignment of >5°, flexion contracture of >10°, mediolateral instability and symptomatic osteoarthritis of a second compartment should be considered as contraindications for unicondylar arthroplasty.


METHODS
In the current article, implantation of the BalanSys® system is presented. Femoral bony resection is solely ligament balanced. The technique allows creation of an optimal extension and flexion gap. Bone cuts were performed using a soft tissue tension device for measuring the extension and flexion gap.


METHODS
Full weight bearing on crutches is allowed immediately after surgery without restriction in flexion. Crutches are recommended for 4 weeks in order to compensate for neuromuscular deficits. Anticoagulation is recommended for 11-14 days according to the AWMF guidelines (S3 guidelines, Release:15 October 2015).


RESULTS
The clinical follow-up after 2 years showed 87 ± 13 points in the knee score and 80 ± 10 points in the function score. The mean range of motion increased from 113°±24° prior to surgery to 122°±23° after surgery. A preoperative extension deficit of 10° was observed in 9 patients and reduced postoperatively in 3 patients.
Zentrum für Orthopädie und Unfallchirurgie, Endoprothesenzentrum Westbrandenburg, Hochschulklinikum der Medizinischen Hochschule Brandenburg Theodor Fontane, Städtisches Klinikum Brandenburg, Hochstrasse 26, 14776, Brandenburg/Havel, Deutschland. r.becker@klinikum-brandenburg.de.
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Becker
Zentrum für Orthopädie und Unfallchirurgie, Endoprothesenzentrum Westbrandenburg, Hochschulklinikum der Medizinischen Hochschule Brandenburg Theodor Fontane, Städtisches Klinikum Brandenburg, Hochstrasse 26, 14776, Brandenburg/Havel, Deutschland.
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Paech
Zentrum für Orthopädie und Unfallchirurgie, Endoprothesenzentrum Westbrandenburg, Hochschulklinikum der Medizinischen Hochschule Brandenburg Theodor Fontane, Städtisches Klinikum Brandenburg, Hochstrasse 26, 14776, Brandenburg/Havel, Deutschland.
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Denecke
D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods* / Q000534:rehabilitation; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery*; D011474:Prosthesis Design; D016896:Treatment Outcome
Fixed bearing inlay; Knee joint; Knee replacement; Prostheses and implants; Unicondylar knee arthroplasty