Abstract
Nowdays bicompartmental arthritis of the knee in patients younger than 60 still remains a challenge for the orthopaedic surgeon. In these selected cases, the authors present their experience in performing a minimally invasive bi-unicompartmental knee replacement assisted by computer navigation.
From January to December 2003, the authors treated seven patients (seven knees) with bicompartmental arthritis of the knee. The mean age was 66 and in all the cases an arthritis deformity was present but with no ligament deficiency and a pain-free femur-patella joint. The Orhophilot (4.0 version) navigation system was used during the surgery to assist prosthesis placement. In all the cases a minimally invasive surgical approach was used (7- to 9-cm skin incision). The patients were assessed using a UKR dedicated outcome score (GIUM Score), pre-operatively and at the latest follow-up. Pre-operatively the mean GIUM score was 49.1 (range 26–63)
At the lastest follow-up the mean GIUM score was 80.2 (range :75–94). The average femoral-tibial angle was 179° (range 177°–181°). In all the cases a good ligament balancing was achieved using a computer-assisted spreader device. All the patients were satisfied and had returned to their previous occupation soon.
The authors underline how the computer navigation system supports ligament balancing and correct prosthesis alignment. They did not register any fracture of the tibial intercondylar eminence because of wrong balancing and incisions. They emphasise this truly minimally invasive surgical approach to the cure of knee arthritis, above all in young patients with post-traumatic deformities.
