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

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Guangzhong Yang ◽  
Xufeng Jiao ◽  
Qianli Li ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Short Term ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
End Stage ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Hybrid Group

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.

scholarly journals Complications, Reasons for Reoperation, and 5-Year Prosthesis Survival Compared Between the Cemented and Cementless Oxford Unicompartmental Knee Arthroplasty Fixation Techniques at Thailand’s Largest National Tertiary Referral Center

2021 ◽  
Author(s):  
Jirayu Paugchawee ◽  
Chaturong Pornrattanamaneewong ◽  
Pakpoom Ruangsomboon ◽  
Rapeepat Narkbunnam ◽  
Keerati Chareancholvanich
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Cox Proportional Hazards Model ◽  
Implant Survival ◽  
Unicompartmental Knee ◽  
Prosthesis Survival ◽  
Significant Difference ◽  
Oxford Unicompartmental Knee Arthroplasty

Abstract Background: Oxford unicompartmental knee arthroplasty (OUKA) yields favorable outcomes in patients with medial compartmental knee osteoarthritis; however, it remains unknown whether cemented or cementless OUKA fixation delivers better outcomes in Asian population. Accordingly, this study aimed to investigate the complications, reasons for reoperation, and 5-year prosthesis survival compared between cemented and cementless OUKA in Thai patients.Methods: A total of 466 cemented and 36 cementless OUKA that were performed during 2011-2015 with a minimum follow-up of five years were included. With reoperation for any reason as the endpoint, Kaplan-Meier analysis was performed to compare 5-year implant survival between groups. Complications, reasons for reoperation, and 90-day morbidity and mortality were compared between groups. Cox proportional hazards model was used to identify independent predictors of implant survival.Results: There was no significant difference in 5-year implant survival between the cemented and cementless groups (96.4% vs. 94.4%, p=0.375). The mean implant survival time was 113.0±0.8 and 70.8±1.9 months in the cemented and cementless groups, respectively (p=0.383). The most common reason for reoperation was bearing dislocation, and only one patient had 90-day morbidity. There was no significant difference between groups for complications or reasons for reoperation. No independent predictors of implant survival were identified in multivariate analysis.Conclusions: OUKA was shown to be a safe and durable reconstructive procedure in Thai patients with medial compartmental knee osteoarthritis. There was no significant difference in implant survival between the cemented and cementless groups during the 5-year follow-up, and no independent predictors of implant survival were identified. Trial registration: Thai Clinical Trials Registry, TCTR20200427004. Registered 27 April 2020 – Retrospectively registered.

scholarly journals The effects of patello-femoral arthrosis to the outcome of unicompartmental arthroplasty

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Tolga Tüzüner ◽  
Ayşe Esin Uygur ◽  
Esra Çirçi ◽  
Murat Eren ◽  
Ziya Demirci
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Knee Society Score ◽  
Oxford Knee Score ◽  
Functional Results ◽  
Unicompartmental Knee ◽  
Number Of Patients ◽  
Significant Difference ◽  
Grade 3

Purpose: Unicompartmental knee arthroplasty is developed for the treatment of unicompartment arthrosis. Participation of multi compartments to the disease and patello-femoral arthrosis classically form a contraindication for this surgery. Different opinions were reported in literature on this subject. In this study, the effects of the presence of patello-femoral arthrosis on post-operative clinical and functional outcomes and revision process were investigated. Method: Pre-operative magnetic resonance (MR) images of 52 patients undergone medial unicompartmental knee arthroplasty between the years of 2011-2016 who completed minimum 6 months of follow-up period were evaluated. According to the presence of patello-femoral arthrosis, patients were classified into groups as non-arthrosis, grade 1-2 and grade 3-4. Statistical comparison were performed on knee society score (KSS), functional knee society score (fKSS), Oxford knee score (OKS), visual analog scale (VAS) score and post-operative joint range of motion (ROM) results. Results: 24 of 52 patients had no patello-femoral arthrosis. 13 patients were diagnosed with grade 1-2 and 15 patients were diagnosed with grade 3-4 patello-femoral arthrosis. No statistically significant difference was observed in patello-femoral arthrosis groups in average post-operative KSS, fKSS, OKS, VAS values. No revision proceeding was demonstrated in regression analysis. Conclusion: The results obtained from this study demonstrated that patello-femoral arthrosis has no effect on clinical and functional results. Yet, it is also considered that there is no factor to affect the implant survival rate. Having that said, when the number of patients and relatively short follow-up periods are considered, it is our opinion that new studies are required in this matter. [Figure: see text]

scholarly journals Radiographic and Clinical Evolution of the Oxford Unicompartmental Knee Arthroplasty

2021 ◽  
Author(s):  
Riccardo D'Ambrosi ◽  
Manuel J. de S.V. da Silva ◽  
João L. M. Moura ◽  
Ilaria Mariani ◽  
Luca D. Serrao ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Tibial Slope ◽  
Phase Iii ◽  
Positive Correlation ◽  
Tibial Resection ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Oxford Unicompartmental Knee Arthroplasty

AbstractThe aim of the study is to evaluate whether the use of the new instrumentation Microplasty (MP) improves component positioning and the reliability of the surgical technique, reducing the implant outliers from the recommended range and providing a more accurate resection, while avoiding insufficient or excessive tibial resection and clinical scores. We prospectively analyzed clinical and radiographic outcomes of three consecutive cohorts for a total of 227 implants at a minimum follow-up of 36 months. The first cohort consisted of 67 Oxford unicompartmental knee arthroplasty (OUKA), using the phase III (Ph-III). The second cohort consisted of 136 OUKA, with the MP instrumentation. The third cohort consisted of 24 hypoallergenic OUKA, using the MP instrumentation (TiNbN). Postoperative alignment of the knee in the coronal and sagittal plane was measured using radiographs. No clinical differences were found among the three groups (p > 0.05). A significant difference was found on the slope between Ph-III and MP (p = 0.0005). Moreover, a significant difference was found in tibial angle and in tibial slope in arthroplasty with femoral size small (S), compared with size medium (M) or large (Ly) (tibia varus/valugs angle: p = 0.0484; tibial slope: p = 0.04). Similar results were found between small (AA, A, B) tibial size and large (C, D, E, F) tibial size for tibial varus/valgus (p = 0.03) angle and tibial slope (p = 0.003). A significant difference was found between Ph-III and MP in tibial slope in patients with body mass index (BMI) ≥25 kg/m2 (p = 0.0003). A positive correlation was noted between the femoral and tibial sizes and the tibial angle and the slope, and a negative correlation between weight and the tibial slope; furthermore, a positive correlation was found between Oxford knee score and radiographic angles. The MP instrumentation seems to be effective in determining the tibial cut and, particularly, improving the tibial slope, compared with Ph-III. The tibial slope is directly affected by the weight and measurements of the components, regardless of the instruments or the number of pegs, while clinical outcomes are correlated with implant position. This prospective comparative study reflects level of evidence II.

Patient-acceptable symptom state for reporting outcomes following unicompartmental knee arthroplasty

2021 ◽  
Vol 103-B (8) ◽  
pp. 1367-1372
Author(s):  
Kevin D. Plancher ◽  
Jasmine E. Brite ◽  
Karen K. Briggs ◽  
Stephanie C. Petterson
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Intact Group ◽  
Unicompartmental Knee ◽  
Significant Difference ◽  
Patient Acceptable Symptom State ◽  
Acl Deficient ◽  
Deficient Group

Aims The patient-acceptable symptom state (PASS) is a level of wellbeing, which is measured by the patient. The aim of this study was to determine if the proportion of patients who achieved an acceptable level of function (PASS) after medial unicompartmental knee arthroplasty (UKA) was different based on the status of the anterior cruciate ligament (ACL) at the time of surgery. Methods A total of 114 patients who underwent UKA for isolated medial osteoarthritis (OA) of the knee were included in the study. Their mean age was 65 years (SD 10). No patient underwent a bilateral procedure. Those who had undergone ACL reconstruction during the previous five years were excluded. The Knee injury Osteoarthritis Outcome Score Activities of Daily Living (KOOS ADL) function score was used as the primary outcome measure with a PASS of 87.5, as described for total knee arthroplasty (TKA). Patients completed all other KOOS subscales, Lysholm score, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Veterans Rand 12-item health survey score. Failure was defined as conversion to TKA. Results Survivorship at ten years was 97% in both the ACL-deficient and ACL-intact groups. The mean survival was 16.1 years (95% confidence interval (CI) 15.3 to 16.8) for the ACL-deficient group and 15.6 years (95% CI 14.8 to 16.361) for the ACL-intact group (p = 0.878). At a mean of nine years (SD 3.5) in the ACL-deficient group, 32 patients (87%) reached the PASS for the KOOS ADL. In the ACL-intact group, at a mean of 8.6 years (SD 3) follow-up, 63 patients (85%) reached PASS for the KOOS ADL. There was no significant difference in the percentage of patients who reached PASS for all KOOS subscales and Lysholm between the two groups. Conclusion PASS was achieved in 85% of all UKAs for KOOS ADL, similar to reports for TKA. Fixed-bearing, medial, non-robotically-assisted UKA resulted in 97% survival at ten years in both the ACL-deficient and ACL-intact groups. There was no significant difference in all outcomes between the two groups. Understanding PASS will allow better communication between surgeons and patients to improve the surgical management of patients with single compartment OA of the knee. This study provides mid- to long-term data supporting the use of PASS to document outcomes following UKA. PASS was met in more than 85% of patients with no differences between ACL-deficient and ACL-intact knees at a mean follow-up of nine years. Cite this article: Bone Joint J 2021;103-B(8):1367–1372.

scholarly journals Short-term effectiveness of medial unicompartmental knee arthroplasty in young patients aged less than or equal to 60 years

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902094511
Author(s):  
Fangxing Wang ◽  
Huaming Xue ◽  
Tong Ma ◽  
Tao Wen ◽  
Tao Yang ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Young Patients ◽  
Visual Analogue Score ◽  
Midterm Results ◽  
Effective Treatment Option ◽  
Unicompartmental Knee ◽  
Before And After

Purpose: The treatment for young patients with advanced knee arthritis by Oxford unicompartmental knee arthroplasty (Oxford-UKA) is still controversial. A relative few studies were published about Asian patients. We evaluated midterm results of Oxford-UKA in young patients aged less than or equal to 60 years. Methods: Between December 2009 and December 2018, 95 patients (109 knees) (mean age 57.48 years; range: 33–60 years) were included. The mean follow-up period was 3.0 years (range: 1.0–9.5 years). The functional outcomes and pain score of the knee before and after surgery were examined. Results: To the last follow-up, no patient died, six patients (nine knees) were lost and one patient underwent total knee revision in case of unexplained postoperative pain. The patients demonstrated significant improvement in range of knee motion (103.65 vs. 115.96, p < 0.05), Oxford Knee Score (40.0 vs. 14.4, p < 0.05), Hospital for Special Surgery Score (56.0 vs. 85.7, p < 0.05), and Visual Analogue Score (VAS) (5.23 vs. 1.08, p < 0.05) before and after surgery. Conclusion: Our midterm results showed that the Oxford-UKA was a reliable and effective treatment option for young patients aged less than or equal to 60 years with anterior medial osteoarthritis. The knee pain can be effectively relieved and excellent functional activities of the knee joint can be obtained after surgery.

Does component placement affect short-term clinical outcome in robotic-arm assisted unicompartmental knee arthroplasty?

2019 ◽  
Vol 101-B (4) ◽  
pp. 435-442 ◽  
Author(s):  
F. Zambianchi ◽  
G. Franceschi ◽  
E. Rivi ◽  
F. Banchelli ◽  
A. Marcovigi ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Outcome ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Robotic Arm ◽  
Short Term ◽  
Soft Tissue Balancing ◽  
Unicompartmental Knee ◽  
Post Implantation

Aims The purpose of this multicentre observational study was to investigate the association between intraoperative component positioning and soft-tissue balancing on short-term clinical outcomes in patients undergoing robotic-arm assisted unicompartmental knee arthroplasty (UKA). Patients and Methods Between 2013 and 2016, 363 patients (395 knees) underwent robotic-arm assisted UKAs at two centres. Pre- and postoperatively, patients were administered Knee Injury and Osteoarthritis Score (KOOS) and Forgotten Joint Score-12 (FJS-12). Results were stratified as “good” and “bad” if KOOS/FJS-12 were more than or equal to 80. Intraoperative, post-implantation robotic data relative to CT-based components placement were collected and classified. Postoperative complications were recorded. Results Following exclusions and losses to follow-up, 334 medial robotic-arm assisted UKAs were assessed at a mean follow-up of 30.0 months (8.0 to 54.9). None of the measured parameters were associated with overall KOOS outcome. Correlations were described between specific KOOS subscales and intraoperative, post-implantation robotic data, and between FJS-12 and femoral component sagittal alignment. Three UKAs were revised, resulting in 99.0% survival at two years (95% confidence interval (CI) 97.9 to 100.0). Conclusion Although little correlation was found between intraoperative robotic data and overall clinical outcome, surgeons should consider information regarding 3D component placement and soft-tissue balancing to improve patient satisfaction. Reproducible and precise placement of components has been confirmed as essential for satisfactory clinical outcome. Cite this article: Bone Joint J 2019;101-B:435–442.

scholarly journals Patient outcomes in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty in China

2020 ◽  
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Womac Score ◽  
Asian Patients ◽  
Unicompartmental Knee ◽  
Group 3 ◽  
Hss Score ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Group 1

Abstract Background: The use of Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly both Western and Asian populations. And Oxford UKA also has excellent functional outcomes with high patient satisfaction. While previous evidence regarding clinical outcomes and survival rate after Oxford UKA based on studies in western populations, results may be different in Asian patients. Thus, the relevance of age for postoperative function after Oxford UKA is therefore still unclear. Hence, the aim of our study was to clarify the effectiveness and safety of Oxford UKA in Asian patients aged over 80 years. Methods: A retrospective review was performed of 195 patients (209 knees)who underwent OxfordUKA between June 2015 and January 2018. We divided all patients into threegroups (ages 60–69; ages 70-79; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients’ knees before surgery and at last follow-up.We also recorded perioperative complications and short-termcomplications. Result: 60 patients (60 knees) between the ages of 60 and 69 (Group 1), 70 patients (79 knees) between the ages of 70-79 (Group 2) and 65 patients (70 knees) over 80 years old (Group 3) were included in the study. The mean follow-up was 21.34±12.04, 22.08±11.38 and 21.76 ± 10.20 months in Group 1, 2 and 3, respectively.At last follow-up, the patients in Group 3 showed lower function scores as compared to group 1 and 2 ( P <0.05), butthe HSS score and the WOMAC score were significantly improved in three groups after surgery. In terms of perioperative and other complications, the three age groups did not differ significantly. Conclusion: Oxford UKA is an effective and safe treatment for osteoarthritis, even in old adult patients in China.Elderly patients have lower knee function scores than younger patients. But the knee joint pain symptoms of the elderly patients are relieved and the function is also improved compare to preoperative condition.

scholarly journals Cemented versus Uncemented Oxford Unicompartmental Knee Arthroplasty: Is There a Difference?

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Burak Akan ◽  
Dogac Karaguven ◽  
Berk Guclu ◽  
Tugrul Yildirim ◽  
Alper Kaya ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Survival Rates ◽  
Operation Time ◽  
Clinical Results ◽  
Knee Prostheses ◽  
Unicompartmental Knee ◽  
The Cost ◽  
Oxford Unicompartmental Knee Arthroplasty

Purpose. The use of uncemented unicompartmental knee prostheses has recently increased. However, few studies on the outcomes of uncemented unicompartmental knee prostheses have been performed. The purpose of this study was to compare the outcomes of cemented and uncemented Oxford unicompartmental knee arthroplasty.Materials and Methods. This retrospective observational study evaluated the clinical and radiological outcomes of 263 medial Oxford unicompartmental prostheses (141 cemented, 122 uncemented) implanted in 235 patients. The mean follow-up was 42 months in the cemented group and 30 months in the uncemented group.Results. At the last follow-up, there were no significant differences in the clinical results or survival rates between the two groups. However, the operation time in the uncemented unicompartmental knee arthroplasty group was shorter than that in the cemented unicompartmental knee arthroplasty group. In addition, the cost of uncemented arthroplasty was greater.Conclusion. Despite the successful midterm results in the uncemented unicompartmental knee arthroplasty group, a longer follow-up period is required to determine the best fixation mode.

scholarly journals Patient Outcomes in Anteromedial Osteoarthritis Patients Over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty in China

2020 ◽  
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Asian Patients ◽  
Unicompartmental Knee ◽  
Group 3 ◽  
Group 2 ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Group 1

Abstract Background: The use of Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly in both Western and Asian populations, with excellent functional outcomes and high patient satisfaction. While previous evidence regarding clinical outcomes and survival rates after Oxford UKA was based on studies in Western populations, the results may be different in Asian patients. The relevance of age for postoperative function after Oxford UKA also remains unclear. Hence, the aim of our study was to clarify the effectiveness and safety of Oxford UKA in Asian patients aged over 80 years.Methods: A retrospective review was performed and included 195 patients (209 knees) who underwent an Oxford UKA between June 2015 and July 2018. We divided the patients into three groups by age: Group 1, 60-69 years; Group 2, 70-79 years; and Group 3, over 80 years. We used the Hospital for Special Surgery (HSS) score and Western Ontario and McMaster (WOMAC) Universities Osteoarthritis Index score to evaluate the general condition of the patients’ knees before surgery and at last follow-up. We also recorded perioperative and short-term complications.Result: Group 1 consisted of 60 patients (60 knees); Group 2, 70 patients (79 knees); and Group 3, 65 patients (70 knees). The mean follow-up was 21.34 ± 12.04, 22.08 ± 11.38, and 21.76 ± 10.20 months in groups 1, 2, and 3, respectively. At last follow-up, the patients in Group 3 showed lower function scores compared to groups 1 and 2 (P <0.05), but the HSS scores and the WOMAC scores were significantly improved in all three groups. In terms of perioperative and other complications, the three age groups did not differ significantly.Conclusion: Oxford UKA is an effective and safe treatment for osteoarthritis, even in elderly patients in China. Elderly patients have lower knee function scores than younger patients. However, the knee joint pain of the elderly patients was relieved and function improved compared to the preoperative condition.

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