FIGURE 4 - uploaded by Takafumi Hiranaka
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The double-spoon technique (A) Accessory spoons. The accessory spoons are spoons of 0.5 mm thickness that can be joined with conventional spoons. (B) Once the accessory spoons are incorporated with the conventional spoon, both spoon levels are the same. (C) The inclination of the spoon indicates the posterior condylar axis when both spoons are inserted into the medial and lateral joint spaces.
Source publication
Bi-unicompartmental knee arthroplasty (BiUKA) is an alternative to total knee arthroplasty for selected patients. Although it is thought to be technically demanding, the technique has not been previously described in detail. Kinematic alignment (KA) implantation and bone cuts parallel to the native joint line would be beneficial to ensure optimal m...
Citations
... Another important indication was varus and valgus deformity before surgery. In valgus deformity a strict limitation most cases, even with an intact ACL 10 . Another potentially useful option in case of bicompartmental femorotibial osteoarthritis (medial and lateral) is biunicompartimental knee arthroplasty (bi-UKA), where both compartments can be resurfaced individually 10 . ...
... In valgus deformity a strict limitation most cases, even with an intact ACL 10 . Another potentially useful option in case of bicompartmental femorotibial osteoarthritis (medial and lateral) is biunicompartimental knee arthroplasty (bi-UKA), where both compartments can be resurfaced individually 10 . In the early literature, bi-UKA was performed for very severe osteoarthritis and rheumatoid arthritis, but indications have evolved over time. ...
... Bicruciate retaining TKA implants preserve both the anterior and the posterior cruciate ligament, hence considered to be offering superior knee kinematics and proprioception. BCR TKA is a possible alternative to conventional TKA, but it is a technically demanding procedure and the results are not always consistent 10 . The BCR implant design was already developed in the early stages of TKA. ...
Total knee arthroplasty (TKA) is a well-known surgical procedure performed to address end stage osteoarthritis. The main goal is to relieve pain, recover articular function and return to normal function as soon as possible. Over the years it is frequently performed in the elderly, but lately there is an increased demand in a younger and more active population. Up to 25% of patients feel dissatisfied about their TKA. The anterior cruciate ligament (ACL) is considered the main anteroposterior stabilizer of the knee; nevertheless the ACL is usually sacrificed during conventional TKA. Research shows this might be an unnecessary sacrifice in certain cases. The considerable dissatisfaction rate in mainly high-demanding patients, together with the literature reports on the importance of the ACL function, were the two main reasons for the development of bicruciate retaining (BCR) total knee arthroplasty. BCR TKA may offer superior knee kinematics and proprioception, through anterior cruciate ligament preservation, but requires a higher level of attention to obtain an accurate and precise component orientation to reach proper ligamentous balancing and restore the native knee biomechanics. Many surgeons abandoned its use due to its challenging technique and inconsistent results. Recent new BCR implant designs are promising. This systematic literature review aims to summarize the current state of BCR TKA and what to expect in the future.
... Unlike MA-TKA, KA-TKA can retain the native joint line with potentially minimized alteration of kinematics and ligament balance along with minimized bone cut volume [5]. The OUKA is a resurfacing surgery and the soft tissue envelope can be retained, so it is reasonable to decide the cutting plane using calipers [9]. A further benefit of this technique is that bulky supplemental parts are unnecessary. ...
In this report, we describe how to revise a failed Oxford unicompartmental knee arthroplasty to kinematically aligned total knee arthroplasty (TKA). Its benefits are the maintenance of the native joint line along with the avoidance of supplemental parts, such as metal augments and stems. This can be applied to patients whose medial tibial cortex is well preserved. The distal cutting plane and rotation alignment are decided before the removal of the femoral component. The tibial cutting plane is up to 12 mm below the lateral joint surface and the varus is up to 5° below the extramedullary rod. Eventually, the native joint line and alignment along with the soft tissue envelope can be well maintained, similar to the restricted kinematically aligned TKA.
