Application of Personalized Navigation Templates to Oxford Single Condylar Replacement in a Chinese Population

Abstract

The purpose of this study is to develop and validate a novel patient-specific navigational template for unicompartmental knee arthroplasty (UKA). A total of 120 patients who underwent UKA were randomized and divided into the conventional method and navigational template groups. In the navigational template group, patient-specific navigational templates were designed and used intraoperatively to assist 60 patients with UKA. Information on operation time and blood loss was recorded by an independent operating room nurse. After surgery, the positions of the prostheses were evaluated using X-rays. All navigation templates were found to fit its corresponding biomodel appropriately without any free movement. The navigational template exhibited significantly better accuracy than the conventional method. Statistically significant differences in the femoral prosthesis flip angle, femoral prosthesis flexion angle, and tibial plateau varus and valgus angle were observed between the two groups (p = 0.022, 0.042, 0.043, respectively). In addition, the mean operation time was statistically and significantly lower in the navigational template group than in the conventional group (p = 0.035). This study introduces a novel navigational template to UKA, the accuracy of which is proven by clinical operation. This is a Level III, therapeutic study.

Keywords

unicompartmental knee arthroplasty - navigation template - Oxford

Note

The work described has not been published before; it is not under consideration for publication anywhere else; its publication has been approved by all coauthors; the work has been performed at Qilu Hospital of Shandong University.

Publikationsverlauf

Eingereicht: 05. März 2019

Angenommen: 07. Januar 2020

Artikel online veröffentlicht:
06. März 2020

• References

• 1 Kim MS, Koh IJ, Choi YJ, Lee JY, In Y. Differences in patient-reported outcomes between unicompartmental and total knee arthroplasties: a propensity score matched analysis. J Arthroplasty 2017; 32 (10) 1453-1459
• 2 Kort NP, van Raay JJ, van Horn JJ. The Oxford phase III unicompartmental knee replacement in patients less than 60 years of age. Knee Surg Sports Traumatol Arthrosc 2007; 15 (04) 356-360
• 3 Pandit H, Hamilton TW, Jenkins C, Mellon SJ, Dodd CA, Murray DW. The clinical outcome of minimally invasive Phase 3 Oxford unicompartmental knee arthroplasty: a 15-year follow-up of 1000 UKAs. Bone Joint J 2015; 97-B (11) 1493-1500
• 4 Broughton NS, Newman JH, Baily RA. Unicompartmental replacement and high tibial osteotomy for osteoarthritis of the knee. A comparative study after 5-10 years' follow-up. J Bone Joint Surg Br 1986; 68 (03) 447-452
• 5 Goodfellow JW, Tibrewal SB, Sherman KP, O'Connor JJ. Unicompartmental Oxford Meniscal knee arthroplasty. J Arthroplasty 1987; 2 (01) 1-9
• 6 Insall J, Aglietti P. A five to seven-year follow-up of unicondylar arthroplasty. J Bone Joint Surg Am 1980; 62 (08) 1329-1337
• 7 Kozinn SC, Scott R. Unicondylar knee arthroplasty. J Bone Joint Surg Am 1989; 71 (01) 145-150
• 8 Kandil A, Werner BC, Gwathmey WF, Browne JA. Obesity, morbid obesity and their related medical comorbidities are associated with increased complications and revision rates after unicompartmental knee arthroplasty. J Arthroplasty 2015; 30 (03) 456-460
• 9 Xing Z, Katz J, Jiranek W. Unicompartmental knee arthroplasty: factors influencing the outcome. J Knee Surg 2012; 25 (05) 369-373
• 10 Chowdhry M, Khakha RS, Norris M, Kheiran A, Chauhan SK. Improved survival of computer-assisted unicompartmental knee arthroplasty: 252 cases with a minimum follow-up of 5 years. J Arthroplasty 2017; 32 (04) 1132-1136
• 11 Jenny JY. Minimally invasive unicompartmental knee arthroplasty. Eur J Orthop Surg Traumatol 2018; 28 (05) 793-797
• 12 Kerens B, Schotanus MG, Boonen B, Kort NP. No radiographic difference between patient-specific guiding and conventional Oxford UKA surgery. Knee Surg Sports Traumatol Arthrosc 2015; 23 (05) 1324-1329
• 13 Pearle AD, van der List JP, Lee L, Coon TM, Borus TA, Roche MW. Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up. Knee 2017; 24 (02) 419-428
• 14 Heyse TJ, Tibesku CO. Lateral unicompartmental knee arthroplasty: a review. Arch Orthop Trauma Surg 2010; 130 (12) 1539-1548
• 15 Boonen B, Schotanus MG, Kort NP. Preliminary experience with the patient-specific templating total knee arthroplasty. Acta Orthop 2012; 83 (04) 387-393
• 16 Gan Y, Ding J, Xu Y, Hou C. Accuracy and efficacy of osteotomy in total knee arthroplasty with patient-specific navigational template. Int J Clin Exp Med 2015; 8 (08) 12192-12201
• 17 Gan Y, Xu D, Lu S, Ding J. Novel patient-specific navigational template for total knee arthroplasty. Comput Aided Surg 2011; 16 (06) 288-297
• 18 Kerens B, Leenders AM, Schotanus MGM. et al. Patient-specific instrumentation in Oxford unicompartmental knee arthroplasty is reliable and accurate except for the tibial rotation. Knee Surg Sports Traumatol Arthrosc 2018; 26 (06) 1823-1830
• 19 Koeck FX, Beckmann J, Luring C, Rath B, Grifka J, Basad E. Evaluation of implant position and knee alignment after patient-specific unicompartmental knee arthroplasty. Knee 2011; 18 (05) 294-299
• 20 Leenders AM, Schotanus MGM, Wind RJP, Borghans RAP, Kort NP. A high rate of tibial plateau fractures after early experience with patient-specific instrumentation for unicompartmental knee arthroplasties. Knee Surg Sports Traumatol Arthrosc 2018; 26 (11) 3491-3498
• 21 Ollivier M, Parratte S, Lunebourg A, Viehweger E, Argenson JN. The John Insall Award: no functional benefit after unicompartmental knee arthroplasty performed with patient-specific instrumentation: a randomized trial. Clin Orthop Relat Res 2016; 474 (01) 60-68
• 22 Sanz-Ruiz P, Matas-Diez JA, Carbo-Laso E, Perez-Mañanes R, Vaquero-Martín J. Patient-specific instrument can improve functional and radiographic results during learning curve for Oxford unicompartmental knee arthroplasty. J Knee Surg 2019; 32 (02) 180-185
• 23 Marmor L. Lateral compartment arthroplasty of the knee. Clin Orthop Relat Res 1984; (186) 115-121
• 24 Bolognesi MP, Greiner MA, Attarian DE. et al. Unicompartmental knee arthroplasty and total knee arthroplasty among Medicare beneficiaries, 2000 to 2009. J Bone Joint Surg Am 2013; 95 (22) e174
• 25 Felts E, Parratte S, Pauly V, Aubaniac JM, Argenson JN. Function and quality of life following medial unicompartmental knee arthroplasty in patients 60 years of age or younger. Orthop Traumatol Surg Res 2010; 96 (08) 861-867
• 26 Liddle AD, Pandit H, Judge A, Murray DW. Patient-reported outcomes after total and unicompartmental knee arthroplasty: a study of 14,076 matched patients from the National Joint Registry for England and Wales. Bone Joint J 2015; 97-B [phone]
• 27 Walker T, Streit J, Gotterbarm T, Bruckner T, Merle C, Streit MR. Sports, physical activity and patient-reported outcomes after medial unicompartmental knee arthroplasty in young patients. J Arthroplasty 2015; 30 (11) 1911-1916
• 28 Vasso M, Del Regno C, D'Amelio A, Viggiano D, Corona K, Schiavone Panni A. Minor varus alignment provides better results than neutral alignment in medial UKA. Knee 2015; 22 (02) 117-121