Der Orthopäde
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Medial unicompartmental knee replacement (UKR) has many advantages over total replacement (TKR) including better function and reduced morbidity. However, the long-term failure rates of fixed-bearing UKR are high, especially because of polyethylene wear. The fully congruent mobile bearing of the Oxford UKR exhibits minimal polyethylene wear, failure from this cause does not seem to occur before 10 years. ⋯ Since 1998, the phase 3 implant has been used with modified instruments through a small incision, avoiding damage to the extensor mechanism. Patients now recover about three times faster than after TKR, and regain much better flexion (mean 135 degrees ). The current evidence supports that the minimally invasive Oxford UKR should be seriously considered as primary treatment for anteromedial compartment osteoarthritis-provided the appropriate surgical expertise is available.
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The acute joint infection is a rare condition; the delayed diagnosis may lead to significant joint destruction. Diagnostic tools are the c-reactive protein and joint aspiration. Today arthroscopic treatment options are suitable tools for the treatment of such conditions. ⋯ The use of intraarticular resorbable antibiotic fleece is possible, but not generally recommended. Suction irrigation systems are only rarely indicated. If there is bony involvement, open arthrotomy still is the golden standard.