Short-term outcomes of Oxford unicompartmental knee arthroplasty with coronal subluxation of the knee: a retrospective case–control study

Abstract

Background The goal of this study was to assess short-term outcomes in single compartment osteoarthritis patients associated with the coronal tibiofemoral subluxation (CTFS) of the knee joint after Oxford unicompartmental knee arthroplasty (OUKA), and to establish the potential impact of the degree of CTFS on operative outcomes. Methods Data pertaining to 183 patients with medial compartment osteoarthritis that underwent OUKA treatment between February 2016 and June 2019 were retrospectively analyzed. The presence and degree of severity of CTFS were assessed using preoperative weight-bearing anteroposterior X-ray images of the knee. Patients were stratified into three subgroups based upon the observed degree of subluxation: a normal group, a mild subluxation group (CTFS < 0.5 cm), and a severe subluxation group (CTFS ≥ 0.5 cm). Anterior and posterior X-ray examination of the knee was conducted at the time of most recent follow-up for each patient to assess the degree of CTFS correction following OUKA. Clinical function was assessed using Oxford knee score (OKS) and Hospital for Special Surgery score (HSS) values, while pain was rated using visual-analog scale (VAS) scores. The mechanical femoral tibial angle (mFTA), range of motion (ROM), and complication rates in these three groups were additionally compared. Results The average follow-up duration for patients in this study was 24.1 months (range: 17–32 months). There were no significant differences in patient age, sex, body mass index (BMI), follow-up duration, mFTA, ROM, OKS, HSS, or VAS scores among these three groups (P > 0.05). After surgery, OKS and HSS scores declined significantly, but no differences in these scores were observed among groups (P > 0.05). Of these patients, 135 (73.8%) were satisfied with the operation, of whom 80 (43.7%) were very satisfied. There were no significant differences in ROM or VAS scores among groups (P > 0.05). The degree of CTFS for patients in the mild and severe subluxation groups was significantly improved following OUKA relative to preoperative values such that the degree of postoperative CTFS did not differ significantly among these groups (P > 0.05). Postoperative mFTA was also significantly improved in these three patient subgroups (P < 0.05). No patients experienced operative complications over the follow-up period. Conclusions OUKA can successfully improve clinical symptoms in patients with single compartmental osteoarthritis. Moreover, OUKA can effectively correct CTFS of the knee in these patients, and the degree of preoperative CTFS has no impact on surgical efficacy. Level of evidence III.

Fostering Excellence in Knee Arthroplasty: Developing Optimal Patient Care Pathways and Inspiring Knowledge Transfer of Advanced Surgical Techniques

“…Historically, TKA meant knee resurfacing of the total knee with a bicondylar femoral component, a total tibial plateau requiring the resection of the anterior cruciate ligament and potentially also the posterior cruciate ligament and, if necessary, the use of a retropatellar polyethylene implant. 22,23 Hinged knee replacements with stemmed fixation were the backbone of revision surgery. Over the years, this portfolio has widened enormously.…”

Change in patellar height in medial and lateral unicompartmental knee arthroplasty: a clinical trial

“…Osteoarthritis of the knee is a major health issue [ 1 – 3 ]. Unicompartmental knee arthroplasty (UKA) is a well-established treatment option in patients with medial or lateral unicompartmental OA since its introduction in 1975 [ 4 – 6 ]. UKA recreates joint space in the affected compartment [ 7 – 10 ].…”

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

“…The early stage of knee osteoarthritis is mainly a mild dull pain in the part of the knee, which is often aggravated after activity and proper rest may be relieved. However, as the disease progresses, the symptoms will become more and more serious [ 7 – 9 ].…”

“…e early stage of knee osteoarthritis is mainly a mild dull pain in the part of the knee, which is often aggravated after activity and proper rest may be relieved. However, as the disease progresses, the symptoms will become more and more serious [7][8][9]. At present, orthopedic clinic has a variety of step-by-step treatment for knee osteoarthritis at different stages of development [10].…”