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Minimally invasive Oxford unicompartmental knee arthroplasty ensures excellent functional outcome and high survivorship in the long term.
Knee Surg Sports Traumatol Arthrosc. 2019 May; 27(5):1658-1664.KS

Abstract

PURPOSE

Whether unicompartimental or total knee arthroplasty is superior for treatment of anteromedial knee osteoarthritis, is still uncertain. Therefore, the purpose of this study was to evaluate clinical and radiological outcome as well as long-term survivorship of medial Oxford unicompartmental knee arthroplasty (OUKA) at an independent center with a minimum follow-up of 10 years.

METHODS

This single-center retrospective cohort study reports the 10-15 years follow-up results of 113 consecutive patients (126 knees) after medial OUKA. Survivorship analysis was performed with several different endpoints and clinical outcome was measured using the Oxford Knee Score (OKS), American Knee Society Score (AKSS-O), range of motion (ROM), Tegner activity score and UCLA score. Radiological analysis was performed with focus on progression of arthritis in the lateral compartment.

RESULTS

A total of 16 patients (16 knees) underwent revision surgery resulting in a survival rate of 92.4% at 10 years and 88.6% at 15 years with the endpoint device-related revisions. The main reason for revision surgery was progression of arthritis in five patients (31.3%) followed by persistency of pain in three patients (18.7%). Clinical outcome was good to excellent with an OKS of 39.9 at 11 years, an AKSS-O of 89.3 and a mean range of motion of 122°. The radiological analysis revealed a significant progression of degenerative changes in the lateral compartment, however without any impact on the functional outcome.

CONCLUSION

Oxford UKA of the medial compartment ensures good long-term survivorship with an excellent functional outcome. Therefore, the results of this study support the continued use of OUKA in patients with anteromedial osteoarthritis.

LEVEL OF EVIDENCE

Retrospective cohort study, Level III.

Authors+Show Affiliations

Center for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.Center for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany.Center for Orthopaedics and Trauma surgery, University of Linz, Krankenhausstr. 7a, 4020, Linz, Austria.Center for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.Center for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.Center for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany.Center for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany. babak.moradi@med.uni-heidelberg.de.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30465099

Citation

Walker, Tilman, et al. "Minimally Invasive Oxford Unicompartmental Knee Arthroplasty Ensures Excellent Functional Outcome and High Survivorship in the Long Term." Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, vol. 27, no. 5, 2019, pp. 1658-1664.
Walker T, Hetto P, Bruckner T, et al. Minimally invasive Oxford unicompartmental knee arthroplasty ensures excellent functional outcome and high survivorship in the long term. Knee Surg Sports Traumatol Arthrosc. 2019;27(5):1658-1664.
Walker, T., Hetto, P., Bruckner, T., Gotterbarm, T., Merle, C., Panzram, B., Innmann, M. M., & Moradi, B. (2019). Minimally invasive Oxford unicompartmental knee arthroplasty ensures excellent functional outcome and high survivorship in the long term. Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA, 27(5), 1658-1664. https://doi.org/10.1007/s00167-018-5299-2
Walker T, et al. Minimally Invasive Oxford Unicompartmental Knee Arthroplasty Ensures Excellent Functional Outcome and High Survivorship in the Long Term. Knee Surg Sports Traumatol Arthrosc. 2019;27(5):1658-1664. PubMed PMID: 30465099.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimally invasive Oxford unicompartmental knee arthroplasty ensures excellent functional outcome and high survivorship in the long term. AU - Walker,Tilman, AU - Hetto,Pit, AU - Bruckner,Thomas, AU - Gotterbarm,Tobias, AU - Merle,Christian, AU - Panzram,Benjamin, AU - Innmann,Moritz M, AU - Moradi,Babak, Y1 - 2018/11/21/ PY - 2018/06/10/received PY - 2018/11/13/accepted PY - 2018/11/23/pubmed PY - 2019/8/17/medline PY - 2018/11/23/entrez KW - Knee arthroplasty KW - Medial unicondylar knee arthroplasty KW - Mobile bearing KW - Oxford knee KW - UKA, UKR, long term survivorship SP - 1658 EP - 1664 JF - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA JO - Knee Surg Sports Traumatol Arthrosc VL - 27 IS - 5 N2 - PURPOSE: Whether unicompartimental or total knee arthroplasty is superior for treatment of anteromedial knee osteoarthritis, is still uncertain. Therefore, the purpose of this study was to evaluate clinical and radiological outcome as well as long-term survivorship of medial Oxford unicompartmental knee arthroplasty (OUKA) at an independent center with a minimum follow-up of 10 years. METHODS: This single-center retrospective cohort study reports the 10-15 years follow-up results of 113 consecutive patients (126 knees) after medial OUKA. Survivorship analysis was performed with several different endpoints and clinical outcome was measured using the Oxford Knee Score (OKS), American Knee Society Score (AKSS-O), range of motion (ROM), Tegner activity score and UCLA score. Radiological analysis was performed with focus on progression of arthritis in the lateral compartment. RESULTS: A total of 16 patients (16 knees) underwent revision surgery resulting in a survival rate of 92.4% at 10 years and 88.6% at 15 years with the endpoint device-related revisions. The main reason for revision surgery was progression of arthritis in five patients (31.3%) followed by persistency of pain in three patients (18.7%). Clinical outcome was good to excellent with an OKS of 39.9 at 11 years, an AKSS-O of 89.3 and a mean range of motion of 122°. The radiological analysis revealed a significant progression of degenerative changes in the lateral compartment, however without any impact on the functional outcome. CONCLUSION: Oxford UKA of the medial compartment ensures good long-term survivorship with an excellent functional outcome. Therefore, the results of this study support the continued use of OUKA in patients with anteromedial osteoarthritis. LEVEL OF EVIDENCE: Retrospective cohort study, Level III. SN - 1433-7347 UR - https://www.unboundmedicine.com/medline/citation/30465099/Minimally_invasive_Oxford_unicompartmental_knee_arthroplasty_ensures_excellent_functional_outcome_and_high_survivorship_in_the_long_term_ L2 - https://dx.doi.org/10.1007/s00167-018-5299-2 DB - PRIME DP - Unbound Medicine ER -