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A 56-year-old man presents with chronic anterior knee pain and the radiographs shown in Figure A. He undergoes the procedure depicted in Figure B. Regarding his prosthesis, which of the following statements is most accurate?
Patellofemoral arthroplasty has superior functional outcomes when compared to either medial or lateral unicompartmental arthroplasty
If disease progression to the medial compartment occurs, the addition of a medial UKA offers more predictable clinical outcomes than conversion to a total knee arthroplasty (TKA)
The most common long-term mode of failure is progression of osteoarthritis to involve the other compartments
Patellar instability is the most common reason for long-term revision to TKA
Aseptic loosening is the most common short-term complication necessitating revision to TKA
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A 61-year-old male had a minimally-invasive unicompartmental knee replacement 8 months ago. He did well until recently when he developed persistent right knee pain that is worse with weight bearing. He denies any fevers or recent trauma. He does report that he had been exercising more over the past few months in an attempt to lose weight. WBC, ESR and C-reactive protein levels are normal. An AP radiograph and bone scan are shown in Figure A and B. What is the most likely cause of his symptoms?
Component failure/ polyethylene failure
Pes anserine bursitis
Complex regional pain syndrome
All of the following are contraindications to medial unicondylar knee arthroplasty EXCEPT:
Flexion contracture greater than 10 degrees
Varus deformity greater than 10 degrees not correctable with stress testing
Lateral knee joint line pain
Osteonecrosis of the medial femoral condyle
A 40-year-old man has moderate lateral compartment arthritis several years after undergoing a partial lateral meniscectomy. He has a correctable 5 degree valgus knee deformity compared to his other limb. His patellofemoral and medial compartments do not show any radiographic signs of degenerative changes. His knee has full range of motion and is stable on exam. After failing nonoperative treatments, which surgical option is most likely to give him the best outcome?
Valgus producing high tibial osteotomy
Varus producing distal femoral osteotomy
Total knee replacement
Arthroscopic debridement and chondroplasty
Tibial tubercle osteotomy with anteromedialization
A 65-year-old female presents to the clinic with isolated medial-sided left knee pain. She has since exhausted conservative management but remains persistently symptomatic. The physical exam and radiographic work-up demonstrates isolated medial tibiofemoral compartment involvement. After discussion of the surgical options, she undergoes the procedure shown in Figure A. She initially does well but returns to clinic 3 months post-operatively with significantly increased medial-sided knee pain and the injury shown in Figure B. All of the following technical errors likely contributed to this complication EXCEPT?
Excessive force impacting the tibial component
Penetration of the posterior tibial cortex with proximal guide pin
Placement of a peripheral medial cortical guide pin
Tibial resection guide replacement with re-drilling of the two proximal guide holes
Under-sizing of the tibial component
Which of the following benefits can be expected from unicompartmental knee arthroplasty compared to total knee arthroplasty for medial compartment knee arthritis?
Better clinical outcomes at one year follow-up.
Greater survivorship rate at 10 year follow-up
Faster postoperative rehabilitation
Better postoperative knee alignment
Reduced risk of secondary surgery within the first year
When performing a unicondylar knee replacement, a smaller incision without dislocation of the patella offers what advantage over a standard, patella-everting approach?
the option to convert to a total knee arthroplasty if needed
more anatomic positioning of the components
better ultimate range-of-motion
increased 10-year implant survival rate
improved rate of recovery
A 60-year-old male tennis player undergoes a unicompartmental knee arthroplasty (UKA) shown in Figures A and B. Which of the following statements regarding this procedure is true?
Compared to total knee arthroplasty (TKA), UKA more closely approximates native knee kinematics
Patients undergoing a UKA and TKA have equivalent blood loss and pain medication requirements
Compared to their TKA counterparts, UKA patients have a slower return to function
There is no difference in range of motion at short or long term follow-up when compared with TKA
Postoperative hospital stay is equivalent for UKA and TKA patients