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EN
Lateral unicompartmental knee arthroplasty (UKA) outcomes have been inferior to those described after medial UKA. Inaccurate implant positioning and mechanical axis malalignment appear to be the most common technical errors. Rare studies or failure identification on lateral UKA are currently presented in the literature. We describe the utilization of computer-assisted lateral UKA placement for lateral knee osteoarthritis with a valgus malalignment of 10°. Navigation allows for a dynamic intraoperative visualisation of the mechanical axis, as well as for accurate component positioning and overall postoperative limb alignment. The systems allow the knee position to be captured with appropriate tension in extension and flexion prior to making definite cuts. Postoperatively, no instabilities occurred with a precise component placement. Navigation can be used in rare cases for lateral UKA.
EN
Core decompression by exact drilling into ischemic lesions of the femoral condyle stays a challenging procedure, particularly in obese patients. The precision of fluoroscopically-based drilling compared to conventional drilling was evaluated in an in-vitro model for obesity. 40 sawbones were prepared mimicking osteonecrosis in obese patients. 20 sawbones were drilled by guidance of an intraoperative navigation system VectorVision® (BrainLAB, Munich, Germany); the other 20 sawbones were conventionally drilled by fluoroscopic control only. Regarding the distance to the desired mid-point of the lesion, a statistically significant difference with 0.55 mm in the navigated group and 1.19 mm in the control group could be stated (p<0.001). Significant differences were further found for the number of drilling corrections (p<0.001) and radiation time needed (p<0.001). Even in difficult circumstances as in obese patients, the drilling guided by the VectorVision®-navigation system shows high precision with simultaneous enormous reduction of radiation time.
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