Medial unicompartmental knee replacement in the under-50s

Parratte, Sébastien; Argenson, Jean-Noël; Pearce, Oliver; Pauly, Vanessa; Auquier, Pascal; Aubaniac, Jean-Manuel

doi:10.1302/0301-620x.91b3.21588

Cited by 99 publications

(65 citation statements)

References 49 publications

(77 reference statements)

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“…These patients are often very active with high and partly unrealistic expectations concerning the ability to return to their activities after UKA, thus potentially dissatisfied even after a technically successful procedure [39,40]. In addition to the functional recovery and the possibility of returning to sporting activity, the limited lifespan of an implant is another major concern in these patients [39,41].…”

Section: Discussionmentioning

confidence: 99%

Sports, Physical Activity and Patient-Reported Outcomes After Medial Unicompartmental Knee Arthroplasty in Young Patients

Walker

Streit

Gotterbarm

et al. 2015

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 99%

Sports, Physical Activity and Patient-Reported Outcomes After Medial Unicompartmental Knee Arthroplasty in Young Patients

Walker

Streit

Gotterbarm

et al. 2015

The Journal of Arthroplasty

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“…Other studies, with smaller numbers, have confirmed that good results can be achieved in young patients with the Oxford UKR at ten years. 12,13 The implant has a mobile bearing which is fully congruent and therefore has minimal wear even at 20 years. [14][15][16] The bearing is unconstrained so there are minimal shear forces at the interfaces and little chance of loosening.…”

Section: Discussionmentioning

confidence: 99%

Unnecessary contraindications for mobile-bearing unicompartmental knee replacement

Pandit

Jenkins

Gill

et al. 2011

The Journal of Bone and Joint Surgery. British volume

185

140

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The contraindications for unicompartmental knee replacement (UKR) remain controversial. The views of many surgeons are based on Kozinn and Scott's 1989 publication which stated that patients who weighed more than 82 kg, were younger than 60 years, undertook heavy labour, had exposed bone in the patellofemoral joint or chondrocalcinosis, were not ideal candidates for UKR. Our aim was to determine whether these potential contraindications should apply to patients with a mobile-bearing UKR. In order to do this the outcome of patients with these potential contraindications was compared with that of patients without the contraindications in a prospective series of 1000 UKRs. The outcome was assessed using the Oxford knee score, the American Knee Society score, the Tegner activity score, revision rate and survival. The clinical outcome of patients with each of the potential contraindications was similar to or better than those without each contraindication. Overall, 678 UKRs (68%) were performed in patients who had at least one potential contraindication and only 322 (32%) in patients deemed to be ideal. The survival at ten years was 97.0% (95% confidence interval 93.4 to 100.0) for those with potential contraindications and 93.6% (95% confidence interval 87.2 to 100.0) in the ideal patients. We conclude that the thresholds proposed by Kozinn and Scott using weight, age, activity, the state of the patellofemoral joint and chondrocalcinosis should not be considered to be contraindications for the use of the Oxford UKR.

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“…This is of particular relevance in regard to the increasing number of young patients undergoing knee replacement. 14 Our aim was to measure the linear wear rate of the Oxford UKR at 20 years, using an accurate and validated RSA method. 15,16 …”

mentioning

confidence: 99%

Polyethylene wear of mobile-bearing unicompartmental knee replacement at 20 years

Kendrick

Simpson

Kaptein

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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The Oxford unicompartmental knee replacement (UKR) was designed to minimise wear utilising a fully-congruent, mobile, polyethylene bearing. Wear of polyethylene is a significant cause of revision surgery in UKR in the first decade, and the incidence increases in the second decade. Our study used model-based radiostereometric analysis to measure the combined wear of the upper and lower bearing surfaces in 13 medial-compartment Oxford UKRs at a mean of 20.9 years (17.2 to 25.9) post-operatively. The mean linear penetration of the polyethylene bearing was 1.04 mm (0.307 to 2.15), with a mean annual wear rate of 0.045 mm/year (0.016 to 0.099). The annual wear rate of the phase-2 bearings (mean 0.022 mm/year) was significantly less (p = 0.01) than that of phase-1 bearings (mean 0.07 mm/year). The linear wear rate of the Oxford UKR remains very low into the third decade. We believe that phase-2 bearings had lower wear rates than phase-1 implants because of the improved bearing design and surgical technique which decreased the incidence of impingement. We conclude that the design of the Oxford UKR gives low rates of wear in the long term.

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Medial unicompartmental knee replacement in the under-50s

Abstract: We retrospectively reviewed 35 cemented unicompartmental knee replacements performed for medial unicompartmental osteoarthritis of the knee in 31 patients Show more

Cited by 99 publications

References 49 publications

Sports, Physical Activity and Patient-Reported Outcomes After Medial Unicompartmental Knee Arthroplasty in Young Patients

Sports, Physical Activity and Patient-Reported Outcomes After Medial Unicompartmental Knee Arthroplasty in Young Patients

Unnecessary contraindications for mobile-bearing unicompartmental knee replacement

Polyethylene wear of mobile-bearing unicompartmental knee replacement at 20 years

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