FEATURED SURGERY: Creating a More Natural-Feeling Knee with a Dual-Pivot Implant
In a pre-recorded surgery presented at ICJR’s 13th Annual Winter Hip & Knee Course, R. Michael Meneghini, MD, performs a cementless primary total knee arthroplasty (TKA) in a 58-year-old active female patient. Dr. Meneghini uses cementless fixation in about 40% of his patients, and he has stopped using a tourniquet with TKA patients except in rare instances.
The procedure was performed in an ambulatory surgery center, and Dr. Meneghini and his team used the Outpatient Arthroplasty Risk Assessment (OARA) score to determine that the patient was an appropriate candidate for surgery in an ASC. [1,2]
Dr. Meneghini chose a dual-pivot implant for this procedure, and in his presentation, he was joined at the podium by Raymond H. Kim, MD, and Gregory G. Polkowski II, MD, MSc, for a discussion of native knee kinematics and the use of the dual-pivot design to provide a more natural-feeling knee. 
Click the image above to watch the surgery and discussion.
This surgical broadcast was supported by DJO.
R. Michael Meneghini, MD, is a Professor of Clinical Orthopaedic Surgery at Indiana University School of Medicine, Fishers, Indiana. He is also Director of the IU Hip & Knee Center.
Raymond H. Kim, MD, is a board-certified orthopaedic surgeon specializing in adult reconstruction of the knee and hip at The Steadman Clinic and Steadman Philippon Research Institute, Vail, Colorado. He is one of the chairs of the 13th Annual Winter Hip & Knee Course
Gregory G. Polkowski II, MD, MSc, is an Associate Professor in the Department of Orthopaedic Surgery, Vanderbilt University, Nashville, Tennessee.
Disclosures: Dr. Meneghini has disclosed that he receives royalties from and is a paid consultant for DJO and OsteoRemedies; that he has stock or stock options in Emovi; that he is a paid consultant for 3M+KCI, Kinamed, and Surgical Care Affiliates; and that he had ownership shares in the IU Health Saxony ambulatory surgery center. Dr. Kim has disclosed that he is a paid presenter for CeramTec; that he is a paid presenter for ConvaTec; that he receives royalties from and is a paid consultant for DJO; and that he receives royalties from Innomed. Dr. Polkowski has disclosed that he is a paid consultant for Bone Support and that he receives royalties from and is a paid consultant for DJO.
- Ziemba-Davis M, Caccavallo P, Meneghini RM. Outpatient joint arthroplasty-patient selection: update on the outpatient arthroplasty risk assessment score. J Arthroplasty. 2019 Jul;34(7S):S40-S43. doi: 10.1016/j.arth.2019.01.007. Epub 2019 Jan 15.
- Meneghini RM, Ziemba-Davis M, Ishmael MK, Kuzma AL, Caccavallo P. Safe selection of outpatient joint arthroplasty patients with medical risk stratification: the “Outpatient Arthroplasty Risk Assessment Score”. J Arthroplasty. 2017 Aug;32(8):2325-2331. doi: 10.1016/j.arth.2017.03.004. Epub 2017 Mar 14.
- Banks SA, Meneghini RM. Achieving more natural motion, stability, and function with a dual-pivot ACL-substituting total knee arthroplasty design. Techniques in Orthopaedics. 2018 March;33(1):48-51.