1.Clinical Outcome Scores Post Medial Unicompartmental Knee Arthroplasty: A Comparison of the MAKO Robotic Arm versus the Oxford Conventional Approach
Tan CMP ; Shih SSW ; Ravichandran V ; Quah ESH ; Kunnasegaran R
Malaysian Orthopaedic Journal 2025;19(No. 1):3-10
Introduction: Unicompartmental knee arthroplasty (UKA)
has significant advantages over total knee arthroplasty
(TKA). However, due to its need for precise positioning and
soft tissue balancing, UKA failures and revision rates may be
higher than that of TKA. Robotic-assisted UKA offers more
accurate implant positioning, soft tissue balancing, improved
lower limb alignment, and a reduction in surgical error.
There are few studies studying functional outcomes post
robotic-assisted UKA. The aim of this study was to compare
the functional outcomes between robotic-assisted and
conventional medial UKA.
Materials and methods: A retrospective review was done of
159 patients; 110 patients underwent conventional UKA
while 49 patients underwent robotic-assisted UKA. Outcome
measures included the Oxford Knee Score (OKS), Knee
Society Score (KSS), Visual Analogue Score (VAS) for pain,
and range of motion (ROM) at three months, one-year and
two years post-UKA.
Results: Pre-operative patient demographics and outcome
scores were not significantly different between both groups.
ROM was significantly greater in the MAKO compared to
the Oxford group at 3 months (p=0.039), 1 year (0.053) and
2 years (0.001) post-operation. While OKS, KSS and VAS
scores improved for both groups, there were no significant
differences in the final outcome measures. None of the
patients experienced a mechanical failure, infection, or
revision post-surgery. One patient each in the Oxford and
MAKO group suffered a periprosthetic fracture.
Conclusion: Both robotic-assisted MAKO UKA and
conventional Oxford UKA showed good clinical outcomes.
Robotic-assisted MAKO UKA had superior ROM outcomes
compared to conventional Oxford UKA up to two years postsurgery
2.Use of Fibrin Glue as a Surgical Adjunct in Bone Grafting of Fracture Non-unions
Kunnasegaran R ; Ng JW ; Kwek EBK
Malaysian Orthopaedic Journal 2024;18(No.2):49-54
Introduction: Non-union of long bones is a common
challenge in the treatment of fractures. Bone grafting is
commonly used to treat atrophic non-union, but mechanical
displacement of the graft may occur, resulting in delay or
failure of treatment. Fibrin glue has demonstrated positive
results in management of bone defects in neurosurgery and
oromaxillary facial surgery, however, there has yet to be any
study on its use in long bone fractures.
Materials and methods: We conducted a prospective
randomised controlled trial at a single tertiary centre
involving adult patients with long bone fractures that had
undergone non-union and requiring bone grafting only.
Autologous iliac crest bone graft was applied to the debrided
non-union site, with additional fibrin glue applied for the
intervention arm. Patients were followed-up with serial
radiographs until clinical and radiographical union.
Results: Ten patients (3 male, 7 female), of mean age 41.7
(19 – 63) were recruited over five years, with one drop out.
Eight out of nine fractures united after treatment. One patient
underwent hypertrophic non-union requiring re-fixation and
bone grafting. There was no difference in the time to union
for patients in the fibrin glue group (19.5 weeks) versus the
control group (18.75 weeks) (p=0.86). There were no
complications sustained from usage of fibrin glue.
Conclusions: Fibrin glue appears to be a safe adjunct for
treatment of non-union of long bone fractures across varying
fracture sites by holding the bone graft in place despite not
demonstrating a faster time to union.


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