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Limited evidence is available on mid-term follow-up for patients with body mass index (BMI) ≥ 40 receiving a unicompartmental knee arthroplasty (UKA). The primary objective of this study was to investigate survival of the UKA in patients with BMI ≥ 40. Secondary objectives were to assess functional and patient reported outcome measures (PROMs). Survival analysis with endpoint revision of any component for any reason was conducted using Kaplan–Meier technique on 121 knees (103 patients) that underwent UKA with Oxford Phase 3 implant (Oxford Knee, Biomet, Swindon, United Kingdom) between September 2001 and March 2014 by seven surgeons. Survivorship differences were compared using Log Rank (Mantel-Cox) tests, and Cox Proportional Hazard Model was used to assess predictors of failure. Preoperative PROMs were compared at 2 and 5 years postoperatively using paired t-tests. Mean age of patients was 58 years (43–75), mean BMI 43 kg/m2 (40–51), and mean follow-up 7 years (2 months to 15 years). Survival rate for the whole cohort was 92% at 2 years and 86% at 5 years. Females had a significantly higher revision rate than males (p = 0.043). A total of 19 knees required revision (16 to TKA, 2 polyethylene liner exchanges, and 1 femoral component and liner revision). With respect to PROMs, there was a significant improvement at 2 and 5 years (p < 0.001) on 4 of 5 knee injury and osteoarthritis outcome score subscales. The mid-term survival rate for the Oxford UKA in patients with morbid obesity is similar to that of other nondesigner patient series with BMI ≥ 30, which provides further evidence for the safety of the implant in this patient population with significant improvements on PROMs at short and mid-term follow-up.

Distal biceps tendon (DBT) tears occur most commonly in middleaged men after a sudden, forced eccentric contraction of the flexed elbow. » An understanding of the multiple risk factors, mechanisms, and pathophysiological causes is essential for proper and timely diagnosis. » High clinical suspicion and routine physical examination with appropriate special examination tests, including the hook test, the passive forearm pronation test, the biceps crease interval test, and the bicipital aponeurosis flex test, can help with rapid and accurate diagnosis and guide appropriate and timely management. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/A713).

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