AANA25 Knee Access Pass-CONCURRENT SESSION 4F: Knee Arthroplasty

Video Transcription

Video Summary

The session focused on knee arthroplasty in sports medicine, addressing when to opt for joint preservation versus replacement and how to ensure successful outcomes, especially in younger, active patients. Dr. Galant introduced the topic, highlighting the rising prevalence of knee arthritis in younger populations and the challenges in treatment decisions. <br /><br />Dr. Gamal discussed the Internal Shock Absorber (ISA or MESHA) device, a minimally invasive implant providing partial joint unloading for medial compartment osteoarthritis, showing sustained pain relief post-removal and comparable unloading effects to high tibial osteotomy (HTO).<br /><br />Dr. Mufti presented mid-term (5+ years) outcomes of combined biologic knee reconstruction—osteochondral allograft (OCA), meniscal allograft transplant (MAT), and corrective osteotomy—demonstrating clinically significant improvements and acceptable reoperation (37%) and failure rates (10%) in a young cohort.<br /><br />Dr. Glashow shared a case of a 30-year-old NFL player undergoing total knee arthroplasty after multiple failed procedures, emphasizing modern implant selection (press-fit, uncemented, cruciate retaining), navigation-assisted surgery, and tailored rehabilitation protocols (including blood flow restriction therapy and neuroleptic use) to meet high functional demands and return to sports.<br /><br />Dr. Jones reviewed literature comparing unicompartmental knee arthroplasty (UKA) versus total knee arthroplasty (TKA) in younger active patients, noting similar functional outcomes but higher revision rates in UKA. Patient selection factors such as BMI, ACL status, and compartmental involvement were highlighted, with robotic assistance improving UKA implantation accuracy.<br /><br />Dr. Maiman detailed implant types, alignment strategies (mechanical to functional alignment spectrum), fixation trends favoring cementless implants in younger patients, and surgical technique utilizing robotic-assisted precise bone cuts and soft tissue balancing, enhancing efficiency and outcomes.<br /><br />The session underscored individualized treatment algorithms balancing patient factors, lesion characteristics, and surgical risks to optimize outcomes in younger, active patients facing knee arthroplasty.

Asset Caption

Moderator: Alexander Golant, M.D.
Andreas H. Gomoll, M.D. | Yusuf Mufti, B.S. | Jonathan L. Glashow, M.D. | Deryk G. Jones, M.D. | David Mayman, M.D.

Keywords

knee arthroplasty

sports medicine

joint preservation

joint replacement

Internal Shock Absorber (ISA)

medial compartment osteoarthritis

osteochondral allograft (OCA)

meniscal allograft transplant (MAT)

total knee arthroplasty (TKA)

unicompartmental knee arthroplasty (UKA)

robotic-assisted surgery