The iDuo Bi-compartmental Knee Replacement: Our Early Experience.
We present the first UK single surgeon case series for the iDuo knee. This is a CT based custom fit monolithic bi-compartmental design that resurfaces both trochlea and condyle. Perceived benefits include maintenance of normal kinematics and preservation of bone stock on the unaffected side. The femoral component is tailored to the patient with no compromise of either the trochlea or femoral geometry.
Patients were selected based on functional ability and physiological age who had an intact symptom free lateral compartment. Knee Society scoring (KSS) was performed pre-operatively and at regular intervals. Patients were asked whether they would undergo the same operation at the one-year mark.
Seven patients have undergone this procedure from 2013 until present. Average age is 60 (Range 55- 82). Average pre-op KSS was 108. All patients consistently scored higher at each interval follow up with excellent results at one year (Av KSS 194). This benefit was seen past two years in all but one in those reaching this point.
ConclusionOur early results suggest that the iDuo knee is a good option for those with isolated bi-compartmental disease and outcome scores are comparable with those reported for the BKA. This bi-compartmental design may bridge the gap between the uni-compartmental and total knee replacement. The choice between monolithic or modular designs remains in debate. We will continue to use this prosthesis for a carefully selected group of patients.
Hopper G, Leach W. (2008) Participation in sporting activities following knee replacement: total versus unicompartmental. Knee Surg Sports Traumatol Arthrosc 16:973.
Saccomanni B. (2010) Unicompartmental knee arthroplasty: a review of literature. Clin Rheumatol 29:339.
Temple MM, Bae WC, Chen MQ, et al. (2007) Age and site associated biomechanical weakening of human articular cartilage of the femoral condyle. Osteoarthritis Cartilage 15:1042.
Berger R, Meneghini R, Sheinkop M, et al. (2004) The progression of patellofemoral arthrosis after medial unicompartmental replacement: results at 11 to 15 years. Clin Orthop Relat Res;92
Parratte S, Pauly V, Aubaniac J- M, Argenson J- NA. (2010) Survival of bicompartmental knee arthroplasty at 5 to 23 years. Clin Orthop Relat Res 468:64–72.
Lonner JH. Modular bicompartmental knee arthroplasty with robotic arm assistance. (2009) Am J Orthop (Belle Mead NJ) 38 (suppl):28–31.
Parratte S, Ollivier M, Opsomer G, et al. (2015) Is knee function better with contemporary modular bicompartmental arthroplasty compared to total knee arthroplasty? Short-term outcomes of a prospective matched study including 68 cases. Orthop Traumatol Surg Res (Epub ahead of print) PMID: 26047754
Thienpont E, Price A. (2013) Bicompartmental knee arthroplasty of the patellofemoral and medial compartments. Knee Surg Sports Traumatol Arthrosc 21:2523–2531.
Yeo NE, Chen JY, Yew A, et al. (2015) Prospective randomised trial comparing unlinked, modular bicompartmental knee arthroplasty and total knee arthroplasty: A five years follow-up. Knee 22:321–327
Engh GA. (2007) A bi-compartmental solution: what the Deuce? Orthopedics 30:770– 771.
Palumbo BT, Henderson ER, Edwards PK, et al. (2011) Initial experience of the Journey- Deuce bicompartmental knee prosthesis: a review of 36 cases. J Arthroplasty 26(suppl):40–45.
Heekin RD, Fokin AA (2014) Incidence of bicompartmental osteoarthritis in patients undergoing total and unicompartmental knee arthroplasty: is the time ripe for a less radical treatment? J Knee Surg 27:77 82.
Heyse TJ, Khefacha A, Cartier P (2010) UKA in combination with PFR at average 12-year follow-up. Arch Orthop Trauma Surg 130:1227–30.
Dennis DA, Komistek RD, Colwell CE Jr, Ranawat CS, Scott RD, Thornhill TS, Lapp MA (1998) In vivo anteroposterior femorotibial translation of total knee arthroplasty: a multicenter analysis. Clin Orthop Relat Res 356:47–57
Stiehl JB, Komistek RD, Cloutier JM, Dennis DA (2000) The cruciate ligaments in total knee arthroplasty: a kinematic analysis of 2 total knee arthroplasties. J Arthroplast 15:545–550
Banks SA, Fregly BJ, Boniforti F, Reinschmidt C, Romagnoli S. (2005) Comparing in vivo kinematics of unicondylar and biunicondylar knee replacements. Knee Surg Sports Traumatol Arthrosc 13:551–556
Lo J, Mu¨ller O, Dilger T, Wu¨lker N, Wu¨nschel M (2011) Translational and rotational knee joint stability in anterior and posterior cruciate-retaining knee arthroplasty. Knee 18:491–495
Wang H, Dungan E, Frame J, Rolston L. (2009) Gait analysis after bicompartmental knee replacement. Clin Biomech 24:751–754
Wang H, Foster J, Francksen N, Estes J, Rolston L. (2015) Lunging after knee replacement surgeries. World Arthroplasty Congress (WAC)
Morrison TA, Nyce JD, Macaulay WB, Geller JA. (2011) Early adverse results with bicompartmental knee arthroplasty: a prospective cohort comparison to total knee arthroplasty. J Arthroplast 26:35–39
Tria A., et al. (2010) “Bicompartmental knee arthroplasty using a single piece femoral component”;American Academy of Orthopaedic Surgeons Feb ; Abstract Podium 680
Koeck F et al. (2011) Evaluation of implant position and knee alignment after patient-specific unicompartmental knee arthroplasty . The Knee 18 ;294–299
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