Unicompartmental Arthroplasty with the Oxford Knee. Buy the book here.
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Videos
Videos and surgical animations relevant to this chapter can be found at www.oxfordpartialknee.com.
Preoperative planning
The trays containing the tibial instruments, templates and trial components and those used with all sizes of femur are shown in Figure 7.1. A numbered list of illustrations of all the instruments, trial components and templates can be found at the end of this chapter. When a component or instrument is mentioned first in the following text, its number will be printed with square brackets.
The five sizes of femoral component have different spherical radii of curvature. For each femoral size, there is a matching set of meniscal bearings in seven thicknesses, from 3 mm to 9 mm. There is a separate tray of instruments for each femoral size. The trays, one of which is shown in Figure 7.2, contain colour coded instruments and trial components specifically for use with one size of femoral component. They must not be mixed up so it is safer just to open one size.
In addition to the instruments in the set, it is important to have the thigh support designed for the OUKA and appropriate saw blades. Three saw blades, reciprocating, oscillating and keel cut have been designed specifically for the OUKA and can be obtained in a three pack or individually (Fig 7.3). The reciprocating and oscillating saws have markings to guide the surgeon to the correct depth. The keel cut saw has two parallel blades with some of the teeth bent in. The saw will not only accurately cut the slot but also remove the residual bone between the cuts. Two sets of Microplasty tibial templates are available. Surgeons just wanting to use cemented components should use cemented templates and cemented keel cut saws. Surgeons who want to use cemented or cementless components should use cementless templates and the cementless keel cut saw blade. (Three-blade saws are available but are more difficult to use in hard bone than the two-blade saws.)
The surgical technique is basically the same for cemented or cementless fixation. Where there are differences, these are highlighted.
Figure 7.1 (a), (b), (c) Tibial instrument trays and (d) femoral tray used for all femoral sizes.
Figure 7.2 Tray for medium femoral components.
