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Minimal-invasive navigiert implantierte unikondyläre Knieendoprothese

Minimally invasive unicondylar knee replacement with computer navigation

  • Leitthema
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Zusammenfassung

Methodik

Im Zeitraum zwischen Januar 2003 sowie Juli 2005 wurden 50 mediale Kniemonoschlitten vom Typ Link St. Georg mit Metal-back-Tibiakomponente in festsitzender Form sowie Uniglide-Prothesen der Fa. Alphanorm/Corin mit Mobile-bearing-Onlay minimal-invasiv implantiert. Postoperativ wurde das Alignement – insbesondere der Tibiakomponente – untersucht, um zu überprüfen, ob der von uns angestrebte dorsale Slope von 5°–7° im Bereich dieser Knieprothesen erreicht wurde.

Ergebnisse

Präoperativ fanden sich Ausgangsvarusfehlstellungen von bis zu 10° Varus und 3° Valgus. Sämtliche Beinachsen konnten zwischen −3° und +3° wiederhergestellt werden. Der dorsale Slope der Kniemonoschlitten bezüglich der Tibiakomponente konnte mit 5,3° im Durchschnitt zwischen 5 und 7° realisiert werden. Die a.-p.-Ausrichtung der Tibiakomponente war ebenso wie die der Femurkomponente regelgerecht.

Schlussfolgerung

Die Navigationsunterstützung führt zu exakteren und reproduzierbareren Ergebnissen bezüglich des für die Monoschlitten so wichtigen tibialen dorsalen Slopes. Eine Überkorrektur der Beinachse wird regelhaft vermieden. Auch die Verwendung zu hoher medialer Onlays wird durch die Navigationskontrolle der Schnitthöhe zuverlässig vermieden.

Abstract

Methods

From January 2003 to July 2005 a total of 50 St Georg medial knee monosleds with metal-backed tibial components in stably seated form and Uniglide prostheses (Alphanorm/Corin) with mobile bearing onlays were implanted in minimally invasive operations. Postoperatively the alignment—especially of the tibial components—was investigated, to check whether we had achieved the dorsal slope we had been aiming at, i.e. 5–7°, in the region of these knee replacements.

Results

Before surgery there were initial malalignments of up to 10° varus and 3° valgus. All leg axes were restored to between –3° and +3°. The desired dorsal slope of 5–7° for the knee monosleds relative to the tibial component was realized, the average slope being 5.3°. The a–p alignment of the tibial component and of the femoral component was correct.

Conclusions

Use of the navigation system leads to more accurate and reproducible results in terms of tibial dorsal slope, which is extremely important when these monosleds are used. Overcorrection of the leg axis is generally avoided. The use of too-high medial onlays is also reliably avoided by the navigation system’s monitoring of the level of the cut.

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Authors and Affiliations

  1. Klinik für Orthopädie, Rheumatologie, Traumatologie St.-Vincenz-Hospital, Danziger Straße 17, 33034, Brakel, Deutschland

    R. G. Haaker, M. Wojciechowski & P. Patzer

  2. Ruhr-Universität Bochum, Bochum, Deutschland

    R. E. Willburger & M. Senkal

  3. Abteilung Orthopädie, Städtische Kliniken Bielefeld, Bielefeld, Deutschland

    M. Engelhardt

Authors
  1. R. G. Haaker
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  2. M. Wojciechowski
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  3. P. Patzer
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  4. R. E. Willburger
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  5. M. Senkal
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  6. M. Engelhardt
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Correspondence to R. G. Haaker.

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Haaker, R.G., Wojciechowski, M., Patzer, P. et al. Minimal-invasive navigiert implantierte unikondyläre Knieendoprothese. Orthopäde 35, 1073–1079 (2006). https://doi.org/10.1007/s00132-006-1006-y

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