Same-Day Outpatient Unicondylar Knee Replacement
by Thomas DeBerardino, MD
Previously, partial knee replacements required a one- to three-day inpatient hospital stay. After discharge, a full recovery would take six weeks. The novel Arthrex iBalance Unicondylar Knee Arthroplasty (UKA) surgical technique, however, allows patients to undergo a partial knee replacement as a true same-day surgery procedure, enabling the patient to leave walking on their knee that same day.
The Arthrex iBalance UKA System is a complete, minimally invasive instrument and implant system for the treatment of localized unicondylar cartilage degeneration secondary to osteoarthritis or post-traumatic arthrosis in the medial or lateral compartments of the knee. The iBalance UKA System incorporates anatomic femoral and tibial resurfacing implants and a unique and innovative instrument set that facilitates a highly accurate, efficient and reproducible surgical technique. The instrumentation set is minimalistic and elegantly designed to be intuitive for the surgeon and OR staff, helping to shorten the learning curve and improve the OR workflow to reduce anesthesia times. The iBalance UKA System provides a predictable, balanced result that ensures near-natural kinematics of the operative knee compartment.
Through a small 3-4 inch parapatellar arthrotomy, surgeons gain excellent exposure to begin the removal of the medial or lateral femoral condyle and damaged cartilage via three simple bony cuts. The tibial plateau is prepared with a sagittal and horizontal bony cut. Appropriate implant sizing is then performed according to the patient’s measurements. The missing portion of the bone and cartilage is replaced with the iBalance Uni femoral trial and tibial bearing trial before cementing the final femoral and tibial components in place. This complete and innovative technology allows patients to have a better, more comfortable recovery at home and avoids a more invasive and painful surgery. The iBalance UKA method removes less bone than traditional methods, allowing patients to recover quicker so they can return to their normal quality of life faster.
Our anesthesia colleagues use regional blocks and light, general anesthesia, allowing patients to go home within an hour of surgery, pain free, with only a soft dressing and crutches for ambulatory assistance. Patients return on postoperative day one or three for their first wound check, bearing full weight on the operative leg using only crutches for support. Patient satisfaction has been universally very high, remarking how much they appreciate the fact that the iBalance UKA System allows for a minimally invasive procedure that negates the need for hospital admission.
