patient has a ligamen-
tously unstable knee
or poor range of
motion before surgery,
he'll have the same
conditions post-opera-
tively. You end up
where you begin, so to
speak. As a rule of
thumb, conditions
such as ligament dam-
age, severe knee stiff-
ness and inflammatory
arthritis are con-
traindications for a
uni. Patients with one
or more of these con-
ditions would be bet-
ter served by having a total knee replacement.
2
Technology and technique
In the early days of freehand technique, the manipulation of the
bones and saws were highly dependent on the skill of the sur-
geon, so the technique was neither refined nor reproducible. Today
we have robotic-arm assisted technology, where the surgeon does the
actual cutting and boring, but the robotic arm guides his hand to pro-
vide greater precision when preparing the surface (see "The Case for
Robotic Unis" on p. 67). Robotic systems are especially well suited for
an orthopod who's not doing a high volume of knee replacements.
We also have 3D-printed, disposable cutting jigs that have been cus-
1 1 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 7
• DO OVER A uni may have a higher revision rate than a total knee, but it's simpler to convert a uni to a
primary knee than to redo a total knee.
Panorama
Orthopedics
and
Spine
Center
