DOS BULLETIN - Dansk Ortopædisk Selskab
DOS BULLETIN - Dansk Ortopædisk Selskab DOS BULLETIN - Dansk Ortopædisk Selskab
2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 72 ABSTRACTS 72
2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 73 UNICAP® focal knee operations – Who are these for? J. O. Laursen Orthopedic Department, County Hospital Soenderborg Background: Introduction: In 2003, a new type of knee hemi-prosthesis was introduced in USA and Europe. HemiCAP was primary developed for articular cartilage lesions in knee, toe, shoulder and hips. In 2006, it was introduced to the Danish market (distributed by Ortotech). By then there was clinical follow up in USA and Europe at 3 years in around 5.000 patients, and the results were promising. 4 years later, the UNICAP was introduced for more advanced cartilage lesions om both femoral and tibial side. Over the years if you deal with surgery of the knee - arthroscopies or total knee replacements- you have seen many patients with minor cartilage lesions and perhaps have tried to inforate, transplant cartilage or utilize chondrocyte transplantation with more or less success. I introduced this implant in 2009, and have so far implanted 45 of these, just using the femoral part! Purpose: Follow-up kohorte study of a new implant concerning focal cartilage lesions in the knee- joint. Methods: Material and methods: There was a protocol for the operations: all patients had preoperative x-rays and MRI taken and all operations started with arthroscopy to confirm the cartilage damage was suitable for further UNICAP surgery and to deal with other damage to meniscus or cartilage. All operations were done with spinal or GA. PC preoperatively and using a tourniquet. Midincision –miniarthrotomy. Postoperative full weight-bearing and range of motion. Discharge 1-3 day postoperatively and controlled by x-rays postop. At 6, 12 weeks and 1 and 2 years including clinically controls with assessing of KSS. All patients were registered in the Danish Knee Society register. VAS – score was registered preoperatively and at follow-ups including KSS, complications and revisions. Findings: 11 women and 12 men is operated till now, with mean age men: 57 years (40- 65); women 62 years (40 – 83). 15 performed in spinal anesthesia and 8 in GA. Operating time (knife time) were average 45 minutes (35 – 80 minutes) including arthroscopy and the UNICAP operation. 12 of the patients were still at work – but had been out of work for an average of 6 months. 7 women and four men were retired. All the workers were at work again in average of 6 months (2 – 12 months). The hospital stay was on average 3 days (2 – 4 days). There were seen no pre- or postoperative complications and no deep infections.One patient had the UNICAP revised to a TKA 6 month’s later. 15 ptt. had more than 3 months follow up and among these, 11 hand meniscus lesions – 11 medial and 3 lateral lesion. KSS knee and functional scores were preoperatively at 56 (30-60) and 38 (30- 70) respectively. And at controls ( >12 weeks ) at 91 ( 50-95 ) and 81 ( 30-90 )( fig 1 ). VAS-score were preoperatively at 7 (6-8) and at control (> 12 weeks) at 2 (1-7). Painkillers were reduced from (1, 2, and 3) to (1, 2) or less. Untill now 45 patients are operated, 27 have passed 3 month's control and 15 one year. 2 patients are revised to a TKA because of progressing arthrosis. Conclusion: So far I have found the UNICAP promishing for restoration of the medial chamber of the knee in patients with isolated focal cartilage lesions or onechamber arthrosis. Further study and follow-ups are nessesary to confirm this. 73
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2010-378_<strong>DOS</strong> nr. 3 2010 29/09/10 10:08 Side 72<br />
ABSTRACTS<br />
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