Lateral unicompartmental knee replacement: fixed or mobile bearing?

Forster, M.C.; Bauze, Adrian; Keene, G

doi:10.1007/s00167-007-0345-5

Cited by 31 publications

(20 citation statements)

References 22 publications

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“…This is similar to what has been achieved in other series of medial and lateral UKRs. 1,24 There are no comparable series of TKR performed for isolated lateral UKR with reported OKS, but in general the OKS following TKR tends to be substantially less than 40. 25,26 The Domed OUKR was introduced in a response to the high dislocation rate seen with previous designs and the unmodified surgical techniques.…”

Section: Discussionmentioning

confidence: 94%

The mid-term outcomes of the Oxford Domed Lateral unicompartmental knee replacement

Weston-Simons

Pandit

Kendrick

et al. 2014

The Bone & Joint Journal

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Mobile-bearing unicompartmental knee replacements (UKRs) with a flat tibial plateau have not performed well in the lateral compartment, owing to a high dislocation rate. This led to the development of the Domed Lateral Oxford UKR (Domed OUKR) with a biconcave bearing. The aim of this study was to assess the survival and clinical outcomes of the Domed OUKR in a large patient cohort in the medium term. We prospectively evaluated 265 consecutive knees with isolated disease of the lateral compartment and a mean age at surgery of 64 years (32 to 90). At a mean follow-up of four years (sd 2.2, (0.5 to 8.3)) the mean Oxford knee score was 40 out of 48 (sd 7.4). A total of 12 knees (4.5%) [corrected] had re-operations, of which four (1.5%) were for dislocation. All dislocations occurred in the first two years. Two (0.8%) were secondary to significant trauma that resulted in ruptured ligaments, and two (0.8%) were spontaneous. In four patients (1.5%) the UKR was converted to a primary TKR. Survival at eight years, with failure defined as any revision, was 92.1% (95% confidence interval 81.3 to 100). The Domed Lateral OUKR gives good clinical outcomes, low re-operation and revision rates and a low dislocation rate in patients with isolated lateral compartmental disease, in the hands of the designer surgeons.

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Section: Discussionmentioning

confidence: 94%

The mid-term outcomes of the Oxford Domed Lateral unicompartmental knee replacement

Weston-Simons

Pandit

Kendrick

et al. 2014

The Bone & Joint Journal

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“…Several studies have compared fixed bearing and mobile bearing results [15-19]. Emerson [15] reported that survivorship analysis based on component loosening and revision showed no statistically significant difference between fixed-bearing and mobile-bearing implants.…”

Section: Discussionmentioning

confidence: 99%

Unicompartmental Knee Resurfacing: Enlarged Tibio-Femoral Contact Area and Reduced Contact Stress Using Novel Patient-Derived Geometries

Steklov¹,

Slamin²,

Srivastav³

et al. 2010

TOBEJ

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Advances in imaging technology and computer-assisted design (CAD) have recently enabled the introduction of patient-specific knee implant designs that hold the potential to improve functional performance on the basis of patient-specific geometries, namely a patient-specific sagittal and coronal curvature, as well as enhanced bone preservation. The objective of this study was to investigate the use of a novel implant design utilizing a patient specific sagittal J-curve on the femoral component combined with a novel constant, patient-derived femoral coronal curvature and to assess tibio-femoral contact area and contact stress on a femur matched curved tibial polyethylene insert. Mean contact area and standard deviations were 81±5, 96±5 and 74±4 mm2 for the heel strike, toe off and mid-stance positions, respectively. Mean contact stress and standard deviations were 23.83±1.39, 23.27±1.14 and 20.78±0.54 MPa for the heel strike, toe off and mid-stance positions, respectively. Standard deviations of the measurements were small, not exceeding 6-7% confirming the consistency of loading conditions across different flexion angles. The results were comparable to those reported for standard, off-the-shelf fixed-bearing implants with paired femoral and tibial geometries. These data show that a constant coronal curvature can be applied to a patient-specific implant by measuring coronal curvatures across the femoral condyle in each patient and by deriving an average curvature. This novel approach combines unique benefits of patient-specific geometry with proven design concepts for minimizing polyethylene wear.

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“…Data from 32 studies were available to compare mobile-bearing vs. fixed-bearing implants; 10 studies (n ¼ 2,268) with mobile-bearing implants [14,18,28,32,33,37,38,41,50,53], 18 studies (n ¼ 1,469) with fixed-bearing [8,26,[42][43][44][45][46][47][48][49]27,30,31,[34][35][36]39,40] and 4 additional studies that reported outcomes for both (n ¼ 1,743 mobile-bearing, n ¼ 790 fixed-bearing) [25,29,46,51]. 18 studies had a moderate risk of bias [8,18,[44][45][46][47][48][49][50]53,26,31,33,34,37,39,42,…”

Section: Fixed-vs Mobile-bearing Componentsmentioning

confidence: 99%

“…Data from 15 studies reported the use of all-PE vs. metal-backed fixedbearing implants; 5 studies (n ¼ 267) with all-PE implants [25,34,36,40,53]; 10 studies (n ¼ 660) with metal-baked implants [8,26,27,29,39,[42][43][44][45][46]. Nine studies had a moderate risk of bias [8,26,34,39,[42][43][44][45][46] and six studies had a serious risk of bias [25,27,29,30,36,40].…”

Section: All-pe Vs Metal-backed Components (Fixed-bearing)mentioning

confidence: 99%

Disease progression, aseptic loosening and bearing dislocations are the main revision indications after lateral unicompartmental knee arthroplasty: a systematic review

et al. 2022

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Lateral unicompartmental knee replacement: fixed or mobile bearing?

Cited by 31 publications

References 22 publications

The mid-term outcomes of the Oxford Domed Lateral unicompartmental knee replacement

The mid-term outcomes of the Oxford Domed Lateral unicompartmental knee replacement

Unicompartmental Knee Resurfacing: Enlarged Tibio-Femoral Contact Area and Reduced Contact Stress Using Novel Patient-Derived Geometries

Disease progression, aseptic loosening and bearing dislocations are the main revision indications after lateral unicompartmental knee arthroplasty: a systematic review

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