The Oxford Knee for unicompartmental osteoarthritis. The first 103 cases

Goodfellow, John; Kershaw, Christopher J.; Benson, MK; O’Connor, JJ

doi:10.1302/0301-620x.70b5.3192563

Cited by 291 publications

(175 citation statements)

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“…The clinical relevance of this study is that it supports the indication for medial UKR as proposed by Goodfellow et al which states that there should be FTCL on both the femur and tibia, identified by radiology (AP standing, varus stress or PA fixed flexion) or arthroscopy, in the medial compartment to achieve optimal results, as in the setting of PTCL worse results are seen 10 . Whilst some knees with PTCL do achieve good and excellent outcomes at present we cannot identify which knees these will be.…”

Section: Discussionsupporting

confidence: 75%

“…UKR implanted for spontaneous osteonecrosis of the knee, based on radiological or histological diagnosis, or that did not fulfil other criteria for UKR: i) retained full thickness cartilage in the lateral compartment, ii) functionally normal medial collateral ligament (MCL), iii) functionally normal anterior cruciate ligament (ACL), iv) absence of bone loss with grooving to the lateral facet of the patella were excluded from the analysis 10 This cohort of patients was matched, 2:1, using propensity score matching based on age, gender and preoperative Oxford Knee Score (OKS) to knees with FTCL AMOA identified from a consecutive series of 1000 UKR (818 patients) implanted by the designer surgeons, between June 1998 and March 2009, for recommended indications 7 .…”

Section: Methodsmentioning

confidence: 99%

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Unsatisfactory outcomes following unicompartmental knee arthroplasty in patients with partial thickness cartilage loss

Hamilton

Pandit

Inabathula

et al. 2017

The Bone & Joint Journal

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Aims While medial unicompartmental knee arthroplasty (UKA) is indicated for patients with full-thickness cartilage loss, it is occasionally used to treat those with partial-thickness loss. The aim of this study was to investigate the five-year outcomes in a consecutive series of UKAs used in patients with partial thickness cartilage loss in the medial compartment of the knee. Patients and Methods Between 2002 and 2014, 94 consecutive UKAs were undertaken in 90 patients with partial thickness cartilage loss and followed up independently for a mean of six years (1 to 13). These patients had partial thickness cartilage loss either on both femur and tibia (13 knees), or on either the femur or the tibia, with full thickness loss on the other surface of the joint (18 and 63 knees respectively). Using propensity score analysis, these patients were matched 1:2 based on age, gender and pre-operative Oxford Knee Score (OKS) with knees with full thickness loss on both the femur and tibia. The functional outcomes, implant survival and incidence of re-operations were assessed at one, two and five years post-operatively. A subgroup of 36 knees in 36 patients with partial thickness cartilage loss, who had pre-operative MRI scans, was assessed to identify whether there were any factors identified on MRI that predicted the outcome. Results Knees with partial thickness cartilage loss had significantly worse functional outcomes at one, two and five years post-operatively compared with those with full thickness loss. A quarter of knees with partial thickness loss had a fair or poor result and a fifth failed to achieve a clinically significant improvement in OKS from a baseline of four points or more; double that seen in knees with full thickness loss. Whilst there was no difference in implant survival between the groups, the rate of re-operation in knees with partial thickness loss was three times higher. Most of the re-operations (three-quarters), were arthroscopies for persistent pain. Compared with those achieving good or excellent outcomes, patients with partial thickness cartilage loss who achieved fair or poor outcomes were younger and had worse pre-operative functional scores. However, there were no other differences in the baseline demographics. MRI findings of full thickness cartilage loss, subchondral oedema, synovitis or effusion did not provide additional prognostic information. Conclusion Medial UKA should be reserved for patients with full thickness cartilage loss on both the femur and tibia. Whilst some patients with partial thickness loss achieve a good result we cannot currently identify which these will be and in this situation MRI is unhelpful and misleading. Cite this article: Bone Joint J 2017;99-B:475–82.

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Section: Discussionsupporting

confidence: 75%

Section: Methodsmentioning

confidence: 99%

Unsatisfactory outcomes following unicompartmental knee arthroplasty in patients with partial thickness cartilage loss

Hamilton

Pandit

Inabathula

et al. 2017

The Bone & Joint Journal

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“…Other early reports also included papers by Marmor (1976) and by Scott and Santore (1981) with series of 124 and 100 knees, respectively. Prerequisites for a UKA such as unicompartmental disease, functioning anterior cruciate ligament, tibiofemoral angles between physiological valgus and 10° varus and no subluxation are largely accepted in retrospective studies (Deschamps et al 1987, Goodfellow et al 1994.…”

Section: 1-20; P = 004) Increased Risk Of Revision Compared To Olmentioning

confidence: 99%

Unicondylar knee replacement for primary osteoarthritis: A prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register

et al. 2007

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Background The choice and use of unicondylar knee arthroplasty (UKA) has gone through a nation wide resurgence at the start of the 21st century in Finland. We evaluated the population-based survival of UKA in patients with primary osteoarthritis (OA) in Finland, and the factors affecting their survival.Method The Finnish Arthroplasty Register was established in 1980. During the years 1985-2003, 1,928 primary UKAs were recorded in the register; 1,819 of these were performed for primary OA. Of these 1,819 UKAs, we selected for further analysis implants that had been used in more than 100 operations during the study period. The survival rates of UKAs were analyzed using Kaplan-Meier analysis and the Cox regression model.Results Analysis of the whole study period showed that UKAs had a 73% (95% CI: 70-76) survival rate at 10 years, with revision for any reason as the end point. Those patients who received the Oxford menisceal bearing unicondylar (n = 1145) had a survival rate of 81% (95% CI: 72-89) at 10 years. The group that received the Miller-Galante II unicondylar (n = 330) had a 79% survival rate (95% CI: 71-87) at 10 years, whereas the Duracon (n = 196) had a survival rate of 78% (95% CI: 72-84) and the PCA (n = 146) had a survival rate of 53% (95% CI: 45-60) at 10 years. The number of UKA operations in Finland has increased markedly in recent years. At the time of operation, the mean age of the patients was 65 (38-91) years. Younger patients (≤ 65 years of age) were found to have a 1.5-fold (95% CI:

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“…proposed by Kozinn and Scott, the indications used for the Oxford UKR lie solely with the 46 pathoanatomy of the disease [3]. The Oxford medial UKR is indicated for the treatment of 47 anteromedial osteoarthritis (AMOA) and spontaneous osteonecrosis of the knee (SONK) [3].…”

Section: Introduction 35mentioning

confidence: 99%

Evidence-Based Indications for Mobile-Bearing Unicompartmental Knee Arthroplasty in a Consecutive Cohort of Thousand Knees

Hamilton

Pandit

Jenkins

et al. 2017

The Journal of Arthroplasty

120

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The Oxford Knee for unicompartmental osteoarthritis. The first 103 cases

Cited by 291 publications

References 0 publications

Unsatisfactory outcomes following unicompartmental knee arthroplasty in patients with partial thickness cartilage loss

Unsatisfactory outcomes following unicompartmental knee arthroplasty in patients with partial thickness cartilage loss

Unicondylar knee replacement for primary osteoarthritis: A prospective follow-up study of 1,819 patients from the Finnish Arthroplasty Register

Evidence-Based Indications for Mobile-Bearing Unicompartmental Knee Arthroplasty in a Consecutive Cohort of Thousand Knees

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