Hybrid Oxford unicompartmental knee arthroplasty has lower residual cement extrusion than cemented arthroplasty in treating end-stage unicompartmental knee osteoarthritis

Abstract

Background Hybrid Oxford unicompartmental knee arthroplasty (OUKA) consists of cementless femoral prostheses and cemented tibial prostheses. Although a hybrid OUKA has been used in clinical practice, the clinical outcome has not been reported. The purpose of this study was to compare the short-term clinical outcomes and rate of residual bone cement extrusion between hybrid and cemented prostheses and analyse the possible reasons for differences between outcomes. Methods A total of 128 knees (118 patients) with end-stage osteoarthritis were included in this study, of which underwent consecutive operations using unicondylar Oxford phase 3 implants from July 2017 and September 2019 in our centre. Follow-up was performed at 6 weeks, 3 and 6 months, 1 year and every year after operation, and complications and changes in the Oxford knee score (OKS) were recorded. The OKS of the two groups was analysed by the generalized estimating equation approach. Prosthesis-based standard fluoroscopy was performed in a timely manner after each operation, and the rate of residual cement extrusion of the two groups was estimated using T-tests and a multivariate regression analysis. Results Excluding the cases that lost follow-up, a total of 120 knees (65 in hybrid group and 55 in cemented group) were included in the analysis. There was no statistically significant difference in patient characteristics between the two groups (p > 0.05). The average follow-up time was 23.4 months (and ranged from 12 to 38 months). As of the last follow-up, there were no complications, such as dislocation, fracture, prosthesis loosening and subsidence, but one patient in the cemented group experienced symptoms caused by residual loose cement. Postoperative OKS in both groups improved significantly (p < 0.001). There was no significant difference in the OKS at any point during the follow-up or in the improvement of the OKS between the two groups (p > 0.05). Residual cement was mainly extruded behind the tibial prosthesis. The rate of hybrid periprosthetic residual cement extrusion was significantly lower in the hybrid group than in the cemented group, and the difference was statistically significant (OR = 3.38; p = 0.014). Conclusions Hybrid OUKA is as effective as cemented OUKA in the short term after operation and can significantly reduce the residual cement extrusion rate around the tibial prosthesis.

Safety and Efficacy of Single Condylar Knee Prosthesis When Treating Knee Single Compartment Osteoarthritis: A Prospective, Case-Randomized Controlled Study

“…Taking revision or imaging prosthesis loosening as the standard, the 10-year survival rate was 98% and the 13-year survival rate was 95.7%. Swienckowski et al reported 41 patients (46 knees) with single condylar replacement of knee joint, whose 11-year survival rate was 92% [ 36 ]. Hopper GP et al have indicated that patients undergoing unicondylar knee prosthesis replacement have a higher quality of life than patients with total knee prosthesis replacement, specifically in 96.7% of patients who can participate in sports activities, while only 63.3% of patients with total knee prosthesis replacement [ 37 ].…”

Analysis of the causes of primary revision after unicompartmental knee arthroplasty: A case series

“…Joint arthroplasty, such as total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA), is often used to treat end-stage unicompartmental knee osteoarthritis[ 1 , 2 ]. Compared with patients who undergo TKA, those who undergo UKA have smaller surgical wounds, recover faster postoperatively, have less blood loss, are more likely to have the anterior and posterior cruciate ligament preserved, as well as proprioception, a lower osteotomy rate, a shorter hospital stay, and lower costs[ 3 - 5 ]. Although UKA has many advantages, the long-term prosthesis survival rate and rate of revision after UKA are still controversial[ 6 , 7 ].…”