SICOT-J最新文献

{"title":"Cemented dual mobility cup for primary total hip arthroplasty: survival and quality of life. A multicenter study.","authors":"Jairo Alonso Rincón, Camilo de la Pava, Rubén Velandia, Sofía Muñoz-Medina, Andre Ferreira","doi":"10.1051/sicotj/2025006","DOIUrl":"10.1051/sicotj/2025006","url":null,"abstract":"<p><strong>Introduction: </strong>Dual mobility cups are characterized by having a prosthetic head inside a polyethylene core that later articulates with a metal cup implanted in the acetabulum. These cups can be cemented or uncemented. This study aimed to determine the survival of a cemented dual-mobility cup (CDMC) with a cobalt-chromium head (CoCr) and the quality of life (QOL) of operated patients.</p><p><strong>Methodology: </strong>Multicenter historical cohort study where survival and QOL were estimated. The cohort includes patients who underwent a primary total hip arthroplasty (THA) with a CDMC and CoCr head. The patients were operated on between 2011 and 2013.</p><p><strong>Results: </strong>40 patients from 6 institutions with a median age of 81 (IQR 22.25) years. The results in the Kaplan-Meier estimation showed a survival of 94.2% (95% CI [86.6% - 100%]) at 5 years and a maximum follow-up of 9.5 years. Three failures occurred (two dislocations and one mechanical loosening), and Oxford Hip Scale (OHS) of 41.5 (IQR 10.50) points was recorded.</p><p><strong>Conclusions: </strong>In terms of survival and the score obtained in the OHS, the CDMC has comparable results with the scientific literature found on uncemented dual mobility cups. This demonstrates adequate results in patients with a maximum follow-up of 9.5 years.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"14"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liposomal bupivacaine versus standard periarticular injections in total hip and knee arthroplasty: a prospective, randomized non-inferiority trial.","authors":"Joseph Bowen, Joshua P Rainey, Jonathan Linthicum, Brenna E Blackburn, Lucas A Anderson","doi":"10.1051/sicotj/2025012","DOIUrl":"10.1051/sicotj/2025012","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous multimodal pain protocols have been developed to optimize pain control, reduce narcotics consumption, and shorten the length of stay after total hip and knee arthroplasty (THA/TKA). Liposomal bupivacaine (LB) has been postulated to reduce narcotic requirements after arthroplasty but is not without additional cost. The aim of this study was to determine if the addition of LB to our standard periarticular injection would improve postoperative pain and shorten the length of stay in patients undergoing TKA or THA.</p><p><strong>Methods: </strong>We performed a prospective randomized, blinded non-inferiority study of patients undergoing THA and TKA. Patients were randomized to a periarticular injection with and without LB. There were 118 hips and 64 knees included in the study with no demographic differences between groups. Post-operative pain management was performed by a second provider who was blinded to the patient's experimental group designation.</p><p><strong>Results: </strong>Cost analysis determined that LB increased cost by $305 dollars per patient when accounting for the cost of injections as well as intravenous and oral pain medications. LB led to a minor reduction in narcotic use in THA patients (equivalent to a single 10 mg oxycodone dose), but this difference may lack clinical relevance. No significant benefits were observed in TKA patients. No difference was identified in self-reported pain scores or lengths of hospital stay.</p><p><strong>Discussion: </strong>The addition of LB did not significantly reduce narcotic consumption in patients undergoing TKA, while the cost of LB is prohibitive and should be considered an area of potential cost savings by surgeons and hospitals. The minor reduction in narcotic use in patients undergoing THA likely lacks clinical significance.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"17"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous metallosis following ceramic insert fracture in total hip arthroplasty: a case report and revision with ceramic-on-ceramic bearing couple.","authors":"Vasileios Giovanoulis, Angelo V Vasiliadis, Simon Marmor","doi":"10.1051/sicotj/2025007","DOIUrl":"10.1051/sicotj/2025007","url":null,"abstract":"<p><p>Ceramic fractures in total hip arthroplasty (THA) are rare complications that pose significant challenges for revision surgery. This case report describes a 68-year-old male who experienced a spontaneous alumina (ceramic) insert and head fracture four years after the initial THA. The first revision with cobalt-chrome and polyethylene components led to severe metallosis, including subcutaneous tissue discoloration. A second revision utilized a ceramic-on-ceramic (CoC) bearing couple, resulting in excellent functional outcomes and resolution of symptoms. Cutaneous pigmentation post-THA is rare and has not been previously reported following a ceramic fracture. The case underscores the need for careful material selection in revision surgery to minimize complications such as metallosis. The decision to use a ceramic-on-ceramic bearing couple in this case proved effective, ensuring durability and reducing the risk of third-body wear, which can result from inadequate management of ceramic fractures and lead to joint, systemic, or cutaneous complications.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"13"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional alignment is a feasible alignment strategy in robotic assisted total knee arthroplasty for knee osteoarthritis with extra-articular deformity - A case series.","authors":"Wei Cheong Eu, Jade Pei Yuik Ho, G Kunalan","doi":"10.1051/sicotj/2024059","DOIUrl":"10.1051/sicotj/2024059","url":null,"abstract":"<p><strong>Introduction: </strong>Extraarticular deformity (EAD) with knee arthritis is a complex condition involving tri-planar bone deformity with pathological malalignment and chronic soft tissue contracture or laxity in the knee joint. Intraarticular correction by TKA, which was previously performed with conventional manual jig by mechanical alignment technique, had its limits and difficulties especially extensive soft tissue release and risk of jeopardizing the collateral ligaments. Robotic technology allows for reproducible and precise execution of surgical plan and allows adjustment to various new personalised alignment philosophy including functional alignment (FA). FA technique involves the adjustment of components positioning that least compromise the soft tissue envelope while restoring the limb alignment and joint obliquity to create a balanced knee. The aim is to study the outcome of intra-articular correction by robotic assisted TKA using Functional Alignment (FA) technique.</p><p><strong>Methodology: </strong>This is a single surgeon series of 8 patients with extraarticular deformity who underwent robotic assisted total knee arthroplasty (TKA) with FA technique. Soft tissue release was gradually released and followed by adjustments of implant positioning in order to achieve a balanced medio-lateral gap.</p><p><strong>Results: </strong>Postoperatively, the lower limb alignment of all patients were restored within 6° (mean 4.54°) based on functional alignment boundaries. Knee phenotype and joint line obliquity (JLO) were restored in comparison to contralateral lower limb. There were 6 varus and 2 valgus malalignment. 7 patients were implanted with posterior stabilized implants while 1 was implanted with cruciate retaining implant. Arc of knee flexion and extension improved (P = 0.002). There was a large postoperative improvement in the Knee Society Score (KSS) (P < 0.001).</p><p><strong>Discussion: </strong>Intraarticular correction by TKA for EAD with knee arthritis is technically reliable with robotic technology. It allows intraoperative adjustment following functional alignment philosophy, thereby, restoring pre-arthritic alignment, knee phenotype and joint line obliquity.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"2"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rectus abdominis tendon insertion to the pubic bone and its clinical implications: A cadaveric study.","authors":"Evangelos A Tourvas, Aristidis H Zibis, Michail E Klontzas, Apostolos H Karantanas, Johannes D Bastian, Theodoros H Tosounidis","doi":"10.1051/sicotj/2024053","DOIUrl":"10.1051/sicotj/2024053","url":null,"abstract":"<p><strong>Purpose: </strong>The primary aim of this study is to determine the rectus abdominis tendon (RAT) insertional anatomy and consequently clarify the extension of secure mobilization of the tendon from the pubic bone in the setting of anterior approaches in pelvic and acetabular reconstruction surgery.</p><p><strong>Materials and methods: </strong>Eleven fresh frozen cadaveric pelvises were dissected by two fellowship-trained orthopaedic trauma surgeons utilizing the anterior intrapelvic approach (AIP). The RAT at the pubic body was dissected, and its footprint on the pubic bone was defined, marked, and measured.</p><p><strong>Results: </strong>Nineteen (19) RAT insertions were analyzed. The average total medial vertical length was 33 mm (range 26-42 mm), and the average total lateral vertical length was 36.5 mm (range 26-46 mm). The total width of the proximal insertion on both sides was measured at an average of 20.42 mm (range 14-24 mm). The average width of the tendon at the transition area between the cranial and caudal areas of the pubic bone was 16.45 mm (range 12-22 mm). The average distal insertion width of the RAT was less than the proximal and middle widths, measuring 10.45 mm (range 8-13 mm).</p><p><strong>Conclusion: </strong>The tendon can be safely mobilized up to an average total medial vertical length of 33 mm (and in no case more than 42 mm) and to an average total lateral vertical length of 36.5 mm (and in no case more than 46 mm). This piece of anatomical information will equip orthopaedic surgeons with a better understanding of the insertional anatomy of the RAT and subsequent safer surgical release when performing anterior approaches to the pelvic ring.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"4"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limited accuracy of transtibial aiming for anatomical femoral tunnel positioning in ACL reconstruction.","authors":"Dimitrios Mastrokalos, Anastasios G Roustemis, Dimitrios Koulalis","doi":"10.1051/sicotj/2025002","DOIUrl":"10.1051/sicotj/2025002","url":null,"abstract":"<p><strong>Background: </strong>Anterior cruciate ligament (ACL) rupture is a common knee injury, and with advancements in knee arthroscopy, ACL reconstruction has become common. Techniques like single-double bundle and femoral tunnel drilling via transtibial or anteromedial portal approaches are available. This study evaluates the accuracy of femoral tunnel placement via these approaches in single-bundle ACL reconstruction.</p><p><strong>Materials and methods: </strong>Forty-three ACL reconstructions using hamstring grafts were analyzed. Initially, femoral tunnels were drilled via the anteromedial portal from 09:30 to 10:00 (14:00 to 14:30 for left knees). Tibial tunnels (mean anteroposterior angle: 63.5°, sagittal: 64.2°) were then created with the same diameter, accompanied by radiological documentation. A femoral aiming device was used to place a K-wire at the center of the femoral tunnel, recorded photographically. Tunnel diameters included 7 mm (20 cases), 7.5 mm (11 cases), 8 mm (7 cases), 8.5 mm (3 cases), and 9 mm (1 case). Two observers evaluated all radiological and photographic data, focusing on the deviation of the transtibial K-wire from the femoral tunnel center.</p><p><strong>Results: </strong>Of 38 evaluated cases, the transtibial K-wire was within the femoral tunnel in 11 cases (28.9%) - 7 cases with 7 mm, 2 cases each with 7.5 mm and 8 mm diameters. In 23 cases (60.5%), the K-wire was at the perimeter or outside the femoral tunnel - 11 cases with 7 mm, 8 with 7.5 mm, 4 with 8 mm, 3 with 8.5 mm, and 1 with 9 mm diameters.</p><p><strong>Conclusion: </strong>Transtibial aiming for anatomical femoral tunnel positioning is challenging. No significant correlation was found between the transtibial deviation and the tibial tunnel diameter.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"8"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study of complications following two-stage bilateral total hip arthroplasty: does inter-stage interval matter?","authors":"Camilo Hernán Bonilla-Ortiz, Jorge Eduardo Manrique-González, Andrés Restrepo-Uribe, Juan Manuel Malagón-Santos, Jorge De Francisco Casas-Galindo, Sofia Muñoz-Medina, Jairo Alonso Rincón-Hoyos","doi":"10.1051/sicotj/2025023","DOIUrl":"10.1051/sicotj/2025023","url":null,"abstract":"<p><strong>Introduction: </strong>This study analyzed complication rates in two-stage bilateral Total Hip Arthroplasty (THA) across three distinct inter-stage intervals to determine the optimal timing for minimizing risk.</p><p><strong>Methods: </strong>This was a retrospective, multicentre, analytic study. The three intervals evaluated were <2 weeks (Group A), 2-12 weeks (Group B), and >12 weeks (Group C). The primary outcomes were blood transfusions, thromboembolic events (TVE), and coronary events, and the secondary outcomes were hospital stay, respiratory complications, reintervention, and mortality. The associations between demographic characteristics and complications and the risk hazard of complications were determined.</p><p><strong>Results: </strong>A total of 331 patients were included: 86 in Group A, 47 in Group B, and 198 in Group C. Blood transfusions after the second THA were performed in 29.1%, 14.9%, and 7.6% of the time interval groups respectively (p = 0.000). One TVE (1.1%) was recorded in group A and 4 (2%) in group C (p = 0.613).</p><p><strong>Conclusions: </strong>Two-stage bilateral THA with a time interval between both surgeries of <2 weeks presented a significantly higher rate of blood transfusions than longer time intervals between surgeries, with an HR of 2.4 (CI: 95% 1.7-3.3, p = 0.000). The incidences of thromboembolic and coronary events were similar between the different timeintervals, demonstrating that two-stage bilateral THA is safe when performed with an interval of at least 2 weeks between both surgeries.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"31"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of oxidized regenerated cellulose powder in perioperative blood management in direct anterior total hip arthroplasty.","authors":"Taizo Kaneko, Kentaro Hayakawa, Tsuyoshi Miyazaki","doi":"10.1051/sicotj/2025036","DOIUrl":"10.1051/sicotj/2025036","url":null,"abstract":"<p><strong>Background: </strong>Perioperative blood loss remains a challenge in total hip arthroplasty (THA). Although tranexamic acid (TXA) is widely used for hemostasis, the efficacy of oxidized regenerated cellulose (ORC) powder as an adjunct in blood management for THA via the direct anterior approach (DAA) remains underexplored. This study aimed to evaluate the effects of ORC powder on perioperative blood loss, hematological parameters, and clinical outcomes in direct anterior THA.</p><p><strong>Methods: </strong>A total of 133 patients who underwent primary THA via the DAA were enrolled in the study. The patients were divided into two groups: the ORC powder group (combination of ORC powder and topical TXA, n = 53) and the control group (topical TXA alone, n = 80). The demographic and clinical information, operative time, intraoperative bleeding volume, estimated total blood loss (eTBL), hidden blood loss (HBL), trends in hemoglobin, hematocrit, postoperative pain scores using a numeric rating scale (NRS), and adverse events were analyzed. Clinical outcomes were assessed using the Japanese Orthopedic Association score.</p><p><strong>Results: </strong>The ORC powder group had significantly lower eTBL (679.1 ± 230.1 mL vs. 875.8 ± 292.9 mL, p < 0.0001) and HBL (424.1 ± 194.5 mL vs. 558.6 ± 264.2 mL, p = 0.002). Postoperative pain scores at postoperative day 7 were lower in the ORC powder group (1.9 ± 1.6 vs. 2.9 ± 2.2, p = 0.009). The clinical outcomes were excellent, and no significant differences were observed in complication rates between the groups.</p><p><strong>Conclusion: </strong>ORC powder effectively reduced perioperative blood loss in THA via the DAA without increasing complication rates. ORC powder has the potential to be a valuable adjunct in optimizing blood management strategies in THA.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"36"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity of a new scoring system for assessment and decision guidance of misplaced pedicular screws.","authors":"Mohamed El-Meshtawy, Moataz Abdelraheem Ahmed, Ibrahim El Sayed Abdellatif Abuomira, Amr Abdelhalem Amr, Mohamed A A Ibrahim","doi":"10.1051/sicotj/2025015","DOIUrl":"https://doi.org/10.1051/sicotj/2025015","url":null,"abstract":"<p><strong>Background: </strong>Pedicle screw fixation in the thoracolumbar spine has become more widely accepted with advancements in instrumentation and clinical efficacy have been made. The optimal way to interpret pedicle screw cortical breaches had the subject of a great deal of research. None of the previous classifications and grading systems include full neurological deficits that may result from screw misplacement and do not provide clear guidance for the management of screw violations, which is crucially needed in the literature.</p><p><strong>Objectives: </strong>Our study aimed to evaluate the reliability and validity of the use of a new scoring system (the Meshtawy Pedicular Screw Malposition - MPSM) for evaluating pedicle screw misplacement by a detailed clinical-radiographic comprehensive scoring system (MPSM) with sharp guidance for treating injurious violations by assessing the correlation between the neurological data of patients and computed tomography (CT) findings.</p><p><strong>Patients and methods: </strong>This prospective case series included 100 patients (508 pedicular screws) who underwent transpedicular fixation at Orthopedic department Al-Azhar University Hospital, Assiut branch, Egypt 255 (50.2%) screws were inserted on the right side, while 253 (49.8%) were inserted on the left side. Intra-observer reliability was examined by calculating Cronbach's alpha intraclass correlation coefficient, which compares three measurements obtained by each observer at different time points. Inter-observer reliability was also examined by calculating Cronbach's alpha intraclass correlation coefficient and comparing the average measurements obtained by each observer.</p><p><strong>Results: </strong>The MPSM demonstrated excellent (100%) intra-observer reliability for each observer regarding the violation score and total MPSM score. A strong positive and statistically significant correlation (Pearson test, P < 0.05) was found between severe neurological deficits and a greater degree of screw-pedicle violation.</p><p><strong>Conclusion: </strong>MPSM scoring is a valid and reliable system for evaluating pedicular screw violations and their possible neurological consequences in the thoracic and lumbosacral spine from D7 to S1. Moreover, grades obtained from the MPSM score are helpful for making clear decisions for management.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"27"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional positioning in robotic medial unicompartmental knee arthroplasty: a step-by-step technique.","authors":"Luca Andriollo, Giovan Giuseppe Mazzella, Christos Koutserimpas, Pietro Gregori, Elvire Servien, Cécile Batailler, Sébastien Lustig","doi":"10.1051/sicotj/2025028","DOIUrl":"10.1051/sicotj/2025028","url":null,"abstract":"<p><p>Unicompartmental knee arthroplasty (UKA) compared to total knee arthroplasty, offers several benefits, though it is associated with a higher revision rate, primarily due to suboptimal implant positioning. Recent advances in robotic-assisted techniques have contributed to more personalized and reproducible procedures. Functional Positioning (FP), a three-dimensional alignment concept, introduces a tailored approach based on a surgical technique that is both effective and reproducible. This article presents a step-by-step surgical technique for medial UKA using FP principles in combination with an image-based robotic system. The technique ensures accurate preoperative planning, real-time intraoperative adjustments, and precise component placement. The key steps of this surgical technique include achieving congruent contact points between the femur and tibia under load across the full range of motion, positioning the implant based on the compliance of the medial soft tissues, planning for a targeted laxity that results in an \"eagle-wing\" appearance, and the use of robotic tools to map cartilage for optimal resurfacing. Future studies will help refine FP strategies and further optimize outcomes in these patients.</p>","PeriodicalId":46378,"journal":{"name":"SICOT-J","volume":"11 ","pages":"34"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12158242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}