Expanding current UKA indication through biomechanical test and novel surgical techniques
- 주제(키워드) UKA , biomechanical test
- 주제(DDC) 610
- 발행기관 아주대학교 일반대학원
- 지도교수 박도영
- 발행년도 2025
- 학위수여년월 2025. 2
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000034635
- 본문언어 영어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Medial unicompartmental knee arthroplasty (UKA) has become a widely utilized treatment for isolated medial compartment osteoarthritis (OA) of the knee, with its popularity continuing to grow globally. Recent clinical studies underscore its success, reporting survivorship rates of over 95% at 10 years and 90% at 20 years. In recent years, the criteria for UKA have broadened. Current indications include unicondylar OA or osteonecrosis, frontal deformities of less than 15°, flexion contractures of less than 15°, and functional integrity of the anterior cruciate ligament (ACL) and peripheral ligaments, with the absence of inflammatory arthropathy. Despite these expanded indications, specific concerns remain: (1) tibial metaphyseal varus deformity, (2) anterior knee pain following UKA in patients with patellofemoral joint osteoarthritis (PFJOA), and (3) higher revision and failure rates of UKA compared to total knee arthroplasty (TKA), despite its excellent overall outcomes. To address these challenges, we aim to further expand the indications for UKA through the development of novel surgical techniques and biomechanical testing. In CHAPTER I, we hypothesized that a fixed-bearing medial UKA results in differences in joint surface angles between the lateral compartment and the operated medial side which could lead to an increase in the joint surface malalignment (JSM) and persistent varus joint line obliquity (JLO) in tibia vara knees, thereby compromising clinical outcomes. We aimed to investigate the clinical outcomes of fixed-bearing medial UKA in tibial vara knees and the associated changes in the JSM and varus JLO. In CHAPTER II, we hypothesized that lateral patellar retinacular release (LPRR) in medial UKA would reduce patellofemoral joint (PFJ) pressure, improving PFJ pain and associated clinical outcomes. We aimed to evaluate the effects of concomitant LPRR during medial UKA by comparing radiologic patellar parameters, PFJ clinical and functional outcomes, as well as changes in intraoperative patellofemoral pressure. In CHAPTER III, we hypothesised that controlled posterior condylar milling (CPCM) would allow for less tibial bone resection while yielding similar clinical outcomes compared to the conventional technique in fixed‐bearing UKA. We aimed to demonstrate the clinical utility of CPCM technique while minimally resecting the tibia during fixed‐bearing UKA.
more목차
Background 1
CHAPTER I: Fixed-bearing unicompartmental knee arthroplasty in tibia vara knee 4
1.1 Introduction 5
1.2. Materials and Methods 8
1.2.1. Study Design 8
1.2.2. Demographics 8
1.2.3. Surgical Treatment 8
1.2.4. Radiographic Analyses 9
1.2.5. Functional Outcomes 12
1.2.6. Data Analyses 12
1.3. Results 14
1.3.1. Radiological Outcomes 14
1.3.2. Functional Outcomes 14
1.4. Discussion 19
CHAPTER II: Effect of concomitant lateral patellar retinacular release during medial unicompartmental knee arthroplasty through biomechanical test 23
2.1 Introduction 24
2.2. Materials and Methods 26
2.2.1. Study Design 26
2.2.2. Surgical Treatment 26
2.2.3. Clinical Outcomes 27
2.2.4. Radiographic Analyses 27
2.2.5. Intraoperative Patello-Femoral Pressure Measurements 30
2.2.6. Data Analyses 32
2.3. Results 33
2.4. Discussion 39
CHAPTER III: Novel surgical technique(controlled posterior condylar milling technique) for unicompartmental knee arthroplasty can minimize tibia resection during appropriate gap balancing 44
3.1 Introduction 45
3.2. Materials and Methods 46
3.2.1. Study Design 46
3.2.2. Surgical Technique 46
3.2.3. Radiographic Analyses 51
3.2.4. Clinical Outcomes 54
3.2.5. Data Analyses 54
3.3. Results 55
3.4. Discussion 59
Conclusion 64
References 65
