Bi-unicompartmental Knee Protheses

  • Sergio Romagnoli
  • Francesco Verde
  • Eddie Bibbiani
  • Nicolò Castelnuovo
  • F. d’Amario


In the past few years, with the introduction of minimally invasive surgery (MIS) and based on excellent unicompartmental prosthesis (UKR) long-term results, we are experiencing a renewed interest in single or associate compartmental substitutions of the knee compared with anterior cruciate ligament (ACL). The UKR prosthesis is used in tissue-sparing surgeries (TSS).1 TSS is a surgical philosophy that mandates a maximum respect for tissues and for anatomy and biomechanics. The aim of TSS is to reduce aggressive local and general surgical procedures, and thereby to optimize the patient’s postoperative course and functional recovery. The surgical access routes in TSS are chosen with respect to the soft tissues, cartilaginous tissue, and bones. Surgical incision of the skin, a soft tissue, is minimized as much as possible while still permitting the intervention and the correct implantation of the prosthesis. The surgery is performed with care taken for the blood vessels and nerves, but also for the musculotendinous apparatus and the capsuloligamentous system.


Anterior Cruciate Ligament Femoral Component Tibial Component Posterior Translation Anterior Cruciate Ligament Deficiency 


  1. 1.
    Pipino F (2006) Tissue sparing surgery (T.S.S.) in hip and knee arthroplasty. J Orthop Traumatol 7:33–35CrossRefGoogle Scholar
  2. 2.
    Gunston FH (1971) Polycentric knee arthroplasty. Prosthetic simulation of normal knee movement. J Bone Joint Surg Br 53(2):272–277PubMedGoogle Scholar
  3. 3.
    Marmor L (1973) The modular knee. Clin Orthop Relat Res 94:242–248CrossRefPubMedGoogle Scholar
  4. 4.
    Romagnoli S, Verde F, Eberle RW (2006) 10-year minimum follow-up of medial unicompartmental knee arthroplasty with the allegretto prosthesis. Presented at AAOS, Chicago 2006, San Francisco 2007; exhibit SE41, Poster P203Google Scholar
  5. 5.
    Romagnoli S (1996) The unicompartmental knee prosthesis and the rotatory gonarthrosis kinematic. In: Current Concept in Primary and Revision, Total Knee Arthroplasty, edited by John N. Insall, W. Norman Scott, Giles R. Scuderi, Lippincott-Raven Publishers, PhiladelphiaGoogle Scholar
  6. 6.
    Cartier P, Sanouiller JL, Grelsamer RP (1996) Unicompartmental knee arthroplasty surgery. 10 years minimum follow-up period. J Arthroplasty 11(7):782–788CrossRefPubMedGoogle Scholar
  7.  7.
    Romagnoli S, Grappiolo G, Ursino N, Broch C (2000) Dexa evaluation of bone remodelling in the proximal tibial after unicompartmental prosthesis. Traumalinc 2:2 Pabst Science PublishersGoogle Scholar
  8.  8.
    Romagnoli S, Grappiolo G, Camera A (1998) Indicazioni e limiti delle protesi monocompartimentali, Il Ginocchio, Anno XIV, vol. 18Google Scholar
  9.  9.
    Romagnoli S, Camera A, Bertolotti M, Arnaldi E (2000) La protesi Bimonocompartimentale con rispetto ricostruzione del LCA, Il Ginocchio, Anno XIV, vol. 19, annoGoogle Scholar
  10. 10.
    Romagnoli S, Camera A, Bertolotti M (2000) Deformità rotatoria e protesi monocompartimentale, Il Ginocchio, Anno XVI, vol. 19Google Scholar
  11. 11.
    Romagnoli S, Banks SA, Fregly BJ, Boniforti F, Reinschmidt C (2005) Comparing in vivo kinematics of unicondylar and bi-unicondylar knee replacement. Knee Surg Sports Traumatol Arthrosc 13(7):551–6CrossRefPubMedGoogle Scholar
  12. 12.
    Romagnoli S (2004) Allegretto: Protesi Monocompartimentale di ginocchio. Pronews, Anno 2 – numero 1, MarzoGoogle Scholar
  13. 13.
    “Die unicondylare Schlittenprothese – (Unicompartmental Knee Arthroplasty). Klaus Buckup Herausgeber, Steinkopff Darmstadt 2005Google Scholar
  14. 14.
    “Bi-Unikondylare Schlittenprothese” S. Romagnoli, F.VerdeGoogle Scholar
  15. 15.
    Romagnoli S., Verde F., Damario F., Castelnuovo N (2006) La protesi femoro-rotulea. Archivio di Ortopedia e Traumatologia 117(1)-Google Scholar
  16. 16.
    Chassin EP, Mikosz RP, Andriacchi TP, Rosenberg AG (1996) Functional analysis of cemented medial unicompartmental knee arthroplasty. J Arthroplasty 11(5):553–559CrossRefPubMedGoogle Scholar
  17. 17.
    Banks SA, Hodge WA (1996) Accurate measurement of three-dimensional knee replacement kinematics using single-plane fluoroscopy. IEEE Trans Biomed Eng 43(6):638–649CrossRefPubMedGoogle Scholar
  18. 18.
    Tupling S, Pierrynowski M (1987) Use of Cardan angles to locate rigid bodies in three-dimensional space. Med Biol Eng Comput 25(5):527–532CrossRefPubMedGoogle Scholar
  19. 19.
    Scott RD, Cobb AG, McQueary FG, Thornhill TS (1991) Uni­compart­mental knee arthroplasty. Eight- to 12-year follow-up evaluation with survivorship analysis. Clin Orthop Relat Res (271):96–100Google Scholar
  20. 20.
    Cloutier JM, Sabouret P, Deghrar A (1999) Total knee arthroplasty with retention of both cruciate ligaments. A nine to eleven-year follow-up study. J Bone Joint Surg 81-A(5):697–702PubMedGoogle Scholar
  21. 21.
    Stiehl JB, Komistek RD, Cloutier JM, Dennis DA (2000) The cruciate ligaments in total knee arthroplasty: a kinematic analysis of 2 total knee arthroplasties. J Arthroplasty 15(5):545–550CrossRefPubMedGoogle Scholar
  22. 22.
    Iwaki H, Pinskerova V, Freeman MAR (2000) Tibio-femoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg 82-B:1189–1195CrossRefGoogle Scholar
  23. 23.
    Hill PF, Vedi V, Williams A, Iwaki H, Pinskerova V, Freeman MAR (2000) Tibiofemoral movement 2: the loaded and unloaded living knee studied by MRI. J Bone Joint Surg 82-B:1196–1198CrossRefGoogle Scholar
  24. 24.
    Komistek RD, Allain J, Anderson DT, Dennis DA, Goutallier D (2002) In vivo kinematics for subjects with and without an anterior cruciate ligament. Clin Orthop Relat Res (404):315–325Google Scholar
  25. 25.
    Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res (248):13–14Google Scholar
  26. 26.
    Goodfellow JW, O’Connor J (1986) Clinical results of the Oxford knee. Surface arthroplasty of the tibiofemoral joint with a meniscal bearing prosthesis. Clin Orthop Relat Res (205):21–42Google Scholar
  27. 27.
    Blankevoort L, Huiskes R, de Lange A (1988) The envelope of passive knee joint motion. J Biomech 21(9):705–720CrossRefPubMedGoogle Scholar
  28. 28.
    Banks SA, Markovich GD, Hodge WA (1997) The mechanics of knee replacements during gait. In vivo fluoroscopic analysis of two designs. Am J Knee Surg 10(4):261–267PubMedGoogle Scholar
  29. 29.
    Banks SA, Hodge WA (2004) 2003 Hap Paul Award Paper of the International Society for Technology in Arthroplasty: design and activity dependence of kinematics in fixed and mobile bearing knee arthroplasties. J Arthroplasty 19(7):809–816CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Sergio Romagnoli
    • 1
  • Francesco Verde
    • 1
  • Eddie Bibbiani
    • 1
  • Nicolò Castelnuovo
    • 1
  • F. d’Amario
    • 1
  1. 1.Centro Chirurgia ProtesicaIstituto Ortopedico “R. Galeazzi”MilanoItaly

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