Analysis of first forty Oxford medial unicompartmental knee replacement from a small district hospital in UK

Keys, Graham W.; Ul-Abiddin, Zain; Toh, Eugene

doi:10.1016/j.knee.2004.03.007

Cited by 55 publications

(22 citation statements)

References 11 publications

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“…Other independent centres reported slightly inferior scores (AKS 71−91 points) [9,13,23]. However, our results are not quite on a par with the excellent results in the designer series studied in Oxford [20,24].…”

Section: Discussioncontrasting

confidence: 73%

Correlation of positioning and clinical results in Oxford UKA

Clarius

Hauck

Seeger

et al. 2009

International Orthopaedics (SICOT)

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In a prospective clinical study, 59 patients with anteromedial osteoarthritis of the knee (61 knee joints) underwent minimally invasive medial Oxford unicompartmental arthroplasty phase 3. Clinical and radiographic examinations of 56 knees were carried out at five (4-7) years. American Knee Society (AKS) scores improved from mean 45.5 (20-80) points (knee score) and 55 (15-100) points (function score) before surgery to 90 (30-100) points in both scores after surgery. The position of each implant was determined on screened radiographs using an image intensifier. The implant position was analysed according to the Oxford X-ray rating system. We evaluated nine measures, and there was no detectable correlation between implant position and clinical result. However, long-term studies are needed before it is possible to elaborate an evidence-based guideline on positioning.

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Section: Discussioncontrasting

confidence: 73%

Correlation of positioning and clinical results in Oxford UKA

Clarius

Hauck

Seeger

et al. 2009

International Orthopaedics (SICOT)

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“…However, longer term reports in the literature of the mobile-bearing Oxford UKR, which have followed unchanged indications for surgery, have identified anterior knee pain or patellofemoral joint problems in a minimal number of cases even in those which have a relatively high instance of revision (5% at 15 years). 5,[13][14][15][16][17][18][19][20] In conclusion, there is good evidence that neither preoperative anterior knee pain nor the presence of medial degeneration of the patellofemoral joint, as seen on skyline radiological views, should be a contraindication for medial Oxford UKR. The situation is less clear for lateral patellar changes, and a more cautious approach is advised.…”

Section: Fig 2bmentioning

confidence: 99%

Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome

Beard

Pandit

Ostlere

et al. 2007

The Journal of Bone and Joint Surgery. British volume

149

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Anterior knee pain and/or radiological evidence of degeneration of the patellofemoral joint are considered to be contraindications to unicompartmental knee replacement. The aim of this study was to determine whether this is the case. Between January 2000 and September 2003, in 100 knees (91 patients) in which Oxford unicompartmental knee replacements were undertaken for anteromedial osteoarthritis, pre-operative anterior knee pain and the radiological status of the patellofemoral joint were defined using the Altman and Ahlback systems. Outcome was evaluated at two years with the Oxford knee score and the American Knee Society score. Pre-operatively 54 knees (54%) had anterior knee pain. The clinical outcome was independent of the presence or absence of pre-operative anterior knee pain. Degenerative changes of the patellofemoral joint were seen in 54 patients (54%) on the skyline radiographs, including ten knees (10%) with joint space obliteration. Patients with medial patellofemoral degeneration had a similar outcome to those without. For some outcome measures patients with lateral patellofemoral degeneration had a worse score than those without, but these patients still had a good outcome, with a mean Oxford knee score of 37.6 (SD 9.5). These results show that neither anterior knee pain nor radiologically-demonstrated medial patellofemoral joint degeneration should be considered a contraindication to Oxford unicompartmental knee replacement. With lateral patellofemoral degeneration the situation is less well defined and caution should be observed.

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“…1,2 Phase 1 and 2 Oxford Knees were implanted through a standard approach, with patellar dislocation, as for a total knee replacement (TKR). Good results have been achieved when used in the medial compartment through an open approach: the survival rate at ten years has been between 90% and 100% in most published series 1,[3][4][5][6][7] (Table I). In addition, Price and Svard 8 have reported a survival rate of 91% at 20 years.…”

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confidence: 99%

Minimally invasive Oxford phase 3 unicompartmental knee replacement

Pandit

Jenkins

Gill

et al. 2011

The Journal of Bone and Joint Surgery. British volume

316

250

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This prospective study describes the outcome of the first 1000 phase 3 Oxford medial unicompartmental knee replacements (UKRs) implanted using a minimally invasive surgical approach for the recommended indications by two surgeons and followed up independently. The mean follow-up was 5.6 years (1 to 11) with 547 knees having a minimum follow-up of five years. At five years their mean Oxford knee score was 41.3 (sd 7.2), the mean American Knee Society Objective Score 86.4 (sd 13.4), mean American Knee Society Functional Score 86.1 (sd 16.6), mean Tegner activity score 2.8 (sd 1.1). For the entire cohort, the mean maximum flexion was 130° at the time of final review. The incidence of implant-related re-operations was 2.9%; of these 29 re-operations two were revisions requiring revision knee replacement components with stems and wedges, 17 were conversions to a primary total knee replacement, six were open reductions for dislocation of the bearing, three were secondary lateral UKRs and one was revision of a tibial component. The most common reason for further surgical intervention was progression of arthritis in the lateral compartment (0.9%), followed by dislocation of the bearing (0.6%) and revision for unexplained pain (0.6%). If all implant-related re-operations are considered failures, the ten-year survival rate was 96% (95% confidence interval, 92.5 to 99.5). If only revisions requiring revision components are considered failures the ten-year survival rate is 99.8% (confidence interval 99 to 100). This is the largest published series of UKRs implanted through a minimally invasive surgical approach and with ten-year survival data. The survival rates are similar to those obtained with a standard open approach whereas the function is better. This demonstrates the effectiveness and safety of a minimally invasive surgical approach for implanting the Oxford UKR.

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Analysis of first forty Oxford medial unicompartmental knee replacement from a small district hospital in UK

Cited by 55 publications

References 11 publications

Correlation of positioning and clinical results in Oxford UKA

Correlation of positioning and clinical results in Oxford UKA

Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome

Minimally invasive Oxford phase 3 unicompartmental knee replacement

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