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Total Knee Replacement Unicondylar Knee Replacement( Uka)
Many patients want a procedure that is not as extensive as a total knee replacement, which is less painful, able to do most of their leisure activities like squatting and “feeling like a natural Knee.” For such patients, there is an option of unicondylar knee replacement. In UKA, just the affected knee segment is resurfaced, and the patient can continue to pursue her activity.
The knee joint can be classified to have three compartments- Medial Tibiofemoral, Lateral Tibiofemoral, and the Patellofemoral joint compartments (Fig-1). Most often, because of the way the knee is designed, patients tend to develop arthritis in the medial tibiofemoral compartment. The majority of the “wear” process happens in this compartment while the other two compartments are mostly healthy. In certain situations, the lateral or the patellofemoral compartments can be replaced.
There are many advantages of unicondylar knee replacement. It replaces only the worn-out compartment and lets the knee feel normal; rehabilitation is quicker, less blood loss and a smaller incision
HTO is another alternative for unicompartmental arthritis. HTO involves the breaking of bones and realignment of the bone, whereas, in UKA, it is less intensive on the bone, fewer short term complications, and early success is better. From a surgeon’s standpoint easier to revise than HTO. But, any foreign body has a higher chance of infection compared to HTO, cannot be advised for people doing manual labor, lifting, or excessive loads on the knee joint.
It is safe to say that UKA can be advised for a 50-70-year-old individual with a desk job, less physical activity, and only one compartment arthritis. The patient must have a healthy functioning knee in the sense that the patient should not have any ligament deficiency, ACL, and PCL should normally be functioning. Have at least 90-100 degrees of motion — little deformity in the knee joint. The patient should not be overweight, and ideally, BMI should be less than 25.
Anybody who is overweight or obese (BMI>30), does manual labor, has a gross deformity, Rheumatoid arthritis is not a candidate for UKA.
Typically UKA survives 80-90 % till the end of the 1st decade and then will need revision. It can be easily revised to a TKA. The problem of a UKA is that the 2nd-decade failure is much higher than a Total Knee Replacement.
A 45-year-old male who presented with inner knee pain, which was unresponsive to conservative measures, was evaluated and planned for a unicondylar knee replacement.
