Clinics in sports medicine
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With the recent increase in medial unicompartmental arthroplasty, this article reviews the design history, indications, results, and modern technique for the implantation of the Oxford mobile-bearing unicompartmental arthroplasty. The article also discusses how the indications for the Oxford differ from the historical indications for medial unicompartmental arthroplasty and supports this paradigm shift with review of the recent data. A detailed series of surgical pearls is also presented to help surgeons with the surgical nuances of the Oxford partial knee.
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Unicondylar knee arthroplasty (UKA) is a challenging surgical procedure for many orthopedic surgeons when compared with total knee arthroplasty (TKA). Given the proven similarities in knee biomechanics between UKA and the native knee and recent evidence showing excellent survivorship and functionality, UKA is an excellent alternative to TKA in the appropriate patient. ⋯ The concerns of complications arising from cannulating the medullary canal and excessive bleeding have not been seen. The intramedullary UKA yields high levels of success and long-term outcomes, with excellent alignment.
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The published recommendations for the nonoperative treatment of osteoarthritis (OA) of the knee include weight loss, physical therapy to strengthen lower-extremity musculature, nonsteroidal antiinflammatories, nutritional supplements, topical treatments, and steroid injections. Evidenced-based results have been mixed using these treatment modalities. The results using unloader braces and viscosupplementation have also been variable. This article reviews the use of conservative treatment of OA of the knee.
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Treatment of medial and lateral compartment arthritis in the anterior cruciate ligament (ACL)-deficient knee remains a topic of debate among orthopedic surgeons. This article discusses the treatment options for the ACL-deficient knee with unicompartmental arthritis and provides a rationale for clinical decision making in this difficult group of patients. Unicondylar knee arthroplasty (UKA) is a viable option in a select group of patients to decrease pain and maintain an active lifestyle. When performing a UKA in an ACL-deficient knee, it is important to manage appropriate expectations for a successful outcome.