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Navigation of minimally invasive technique can improve results of mobile-bearing UKR

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Jean-Yves Jenny

COPENHAGEN — The use of computer-aided systems to help facilitate precise implantation of mobile-bearing unicompartmental knee replacements has improved 2-year follow-up findings, according to French researchers. Jean-Yves Jenny, MD, reported his team’s findings at the 12th EFORT Congress 2011, here.

Although mobile-bearing unicompartmental knee replacement (UKR) is considered more difficult, Jenny noted his team hoped navigation would compensate.

“We used mobile-bearing unicompartmental prostheses,” Jenny said. “Mobile-bearing unicompartmentals decrease polyethylene wear, but the operative technique is more demanding because of a higher risk of a dislocation. We are hoping navigation might address this issue.”

In the study, 60 patients underwent the procedure with 81 of those patients meeting the 2-year follow-up minimum. Jenny’s team recorded complications and analyzed clinical results through the Knee Society Scoring System, as well as the Oxford Knee Questionnaire. Postoperative lateral long leg and AP X-rays were used to analyze the accuracy of implantation.

Jenny reported eight complications associated with the implant or operative technique his team used. These complications included two meniscus instability cases, two tibia loosening cases, two femoral loosening cases, one lateral disease progression case and one case of unexplained pain syndrome.

Overall mean Knee Score was 93 points, with 44% of patients demonstrating a score of 100 points and 10% demonstrating a score of less than 85 points. The team reported a 2-year survival rate of 97%, a mean Function Score of 97 points — with 84% reporting the maximum of 100 points and 5% reporting less than 85 points — and mean Oxford Knee Questionnaire score of 19 points.

Seventy-seven percent of cases met expected limb axis correction, Jenny reported, with 62% of cases displaying “an optimally implanted prosthesis for all studied criteria.” He attributed revision cases in his study to technical difficulties observed during the development phase of the procedure.

“Implant fixation has been improved, and some of the mistakes have been corrected,” Jenny said. “Since those improvements, no loosening has been observed. We consider that the association between the minimally invasive approach with navigation and the mobile-bearing implant is an interesting idea. We keep improving this technique thanks to the convincing results we have had.”

Reference:

• Jenny J, Saussac F, Pascal L. Navigated, minimal invasive, mobile bearing unicompartmental knee prosthesis. A 2-year follow-up study. Paper #277. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen.

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