Our Summary

This research paper is about a type of knee surgery called lateral unicompartmental knee arthroplasty. This procedure can have excellent results for the right patients. However, more research is needed to see if this type of surgery could be beneficial for other groups of patients as well.

The paper also discusses how new technologies like robotics, custom implants, and navigation technology could make this type of knee surgery easier to perform and more successful.

There’s a need for improvement in the specific implants used for this type of surgery. The paper notes that certain types of implants, called mobile-bearing devices, can sometimes fail because parts of the device dislocate. More research is needed on this issue, especially with newer types of these devices.

The paper recommends that future research studies should look at two types of knee surgery — medial unicompartmental knee arthroplasty and lateral unicompartmental knee arthroplasty — separately. This will help researchers understand the specific details and differences between these two types of surgery better.

FAQs

  1. What are the potential benefits of using robotics, custom implants, and navigation technology in lateral unicompartmental knee arthroplasty?
  2. Why are there few lateral-specific implants currently available and how can their development improve the outcomes of knee replacement surgeries?
  3. What are the potential issues with mobile-bearing devices in knee arthroplasty and what further studies are needed to evaluate these complications?

Doctor’s Tip

A helpful tip a doctor might tell a patient about knee replacement is to follow the post-operative rehabilitation and physical therapy plan diligently. This will help ensure proper healing, strengthen the muscles around the knee, and improve range of motion. It is important to communicate any concerns or pain experienced during recovery with your healthcare provider to address them promptly. Additionally, maintaining a healthy weight and staying active with low-impact exercises can help prolong the life of the knee replacement.

Suitable For

Patients who are typically recommended for knee replacement surgery are those with severe osteoarthritis or other degenerative joint diseases that result in significant pain and functional limitations. Specifically, for lateral unicompartmental knee arthroplasty, patients with isolated lateral compartment osteoarthritis and intact anterior and posterior cruciate ligaments are generally considered good candidates. These patients should have good bone quality and alignment, as well as minimal deformity or instability in the knee joint.

It is important for patients to have realistic expectations about the potential benefits and risks of knee replacement surgery, as well as to have exhausted conservative treatment options before considering surgery. Patients should also be in overall good health and have a strong commitment to post-operative rehabilitation and physical therapy to achieve optimal outcomes.

Ultimately, the decision to undergo knee replacement surgery should be made in consultation with a qualified orthopedic surgeon who can evaluate the individual patient’s specific condition and determine the most appropriate treatment plan.

Timeline

Before knee replacement:

  1. Patient experiences chronic knee pain, stiffness, and swelling that does not improve with conservative treatments such as medication, physical therapy, or injections.
  2. Patient undergoes imaging tests such as X-rays, MRI, or CT scans to assess the extent of damage to the knee joint.
  3. Patient consults with an orthopedic surgeon to discuss the possibility of knee replacement surgery and determine if they are a suitable candidate for the procedure.
  4. Pre-operative preparations, including blood tests, medical clearance, and physical therapy to strengthen the surrounding muscles and improve range of motion.
  5. Patient attends a pre-operative education session to learn about the surgery, recovery process, and post-operative care.

After knee replacement:

  1. Patient undergoes knee replacement surgery, which typically lasts 1-2 hours under general or regional anesthesia.
  2. Patient stays in the hospital for a few days for monitoring and rehabilitation with the help of physical therapists.
  3. Patient gradually resumes activities of daily living, including walking with the help of assistive devices and performing exercises to improve strength and flexibility.
  4. Patient attends follow-up appointments with the surgeon to monitor healing progress, address any concerns, and adjust the rehabilitation plan as needed.
  5. Patient continues physical therapy and exercises at home to further improve mobility, reduce swelling, and prevent complications such as stiffness or infection.
  6. Over the course of several weeks to months, patient experiences gradual improvement in pain relief, range of motion, and functional abilities, ultimately leading to a return to normal activities and improved quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with lateral unicompartmental knee arthroplasty?
  2. What is the expected recovery time and rehabilitation process after surgery?
  3. How long can I expect the implant to last, and what factors may affect its longevity?
  4. Are there any specific restrictions or limitations I should be aware of after the surgery?
  5. What are the alternative treatment options available for my condition, and why is a knee replacement recommended in my case?
  6. How experienced are you in performing lateral unicompartmental knee arthroplasty, and what is your success rate with this procedure?
  7. Will I need any additional imaging or tests before the surgery to ensure that I am a good candidate for a knee replacement?
  8. What type of implant will be used for the surgery, and are there any potential advantages or disadvantages to consider with different implant options?
  9. How can I best prepare for the surgery, both physically and mentally?
  10. What post-operative follow-up care and monitoring will be necessary, and how long will I need to continue with physical therapy or rehabilitation exercises?

Reference

Authors: Smith E, Lee D, Masonis J, Melvin JS. Journal: JBJS Rev. 2020 Mar;8(3):e0044. doi: 10.2106/JBJS.RVW.19.00044. PMID: 32149936