Mid-term results of oxford medial unicompartmental knee arthroplasty

Abstract

Background: This study examined the clinical and radiologic mid-term results of patients treated by Oxford minimally invasive unicompartmental knee arthroplasty.

Methods: One hundred and eighty-eight knees of unicompartmental knee arthroplasties with Oxford Uni® in 166 patients (16 males and 150 females), which were performed between 2002 and 2005, were reviewed. The mean age was 65.3 years (range, 44 to 82 years) and the mean follow-up period was 79.8 months (range, 56 to 103 months). The preoperative diagnosis was osteoarthritis in 166 patients, osteonecrosis of the medial femoral condyle in 20 and chondrocalcinosis in 2.

Results: The mean Hospital for Special Surgery (HSS) knee score was 67.5 (range, 52 to 75) preoperatively and 89.9 (range, 85 to 100) at the final follow-up. The mean preoperative flexion contracture was 6.5° (range, 0 to 15°) and 0.8° (range, 0 to 5°) at the final follow-up. The mean full flexion increased from 135° (range, 90 to 150°) preoperatively to 150° (range, 140 to 165°) at the final follow-up. Active full flexion was possible within 2 postoperative months. The squatting and cross-leg postures were possible in 133 patients (80.1%) and 152 patients (91.6%) at the final follow-up. The mean tibiofemoral angle was improved from varus 1.5° to valgus 4.8°. Complications were encountered in 18 cases (9.5%). A bearing dislocation occurred in 10 cases (5.3%), tibial component loosening in 4 cases (2.1%), femoral loosening in 3 cases (1.6%) and lateral translation in 1 case (0.5%). The mean time for a bearing dislocation was 22.6 months (range, 3 to 70 months) postoperatively. Seven cases returned to the predislocation level of activity with the insertion of a thicker bearing and 3 cases converted to total knee arthroplasty.

Conclusions: Minimally invasive unicompartmental knee arthroplasty with Oxford Uni® provided rapid recovery, good pain relief and excellent function suitable for the Korean lifestyle. In contrast, the high complication rates of Oxford Uni® encountered in the mid-term results suggested less reliability than total knee arthroplasty.

Keywords: Knee; Unicompartmental knee arthroplasty.

Fig. 1

Cumulative rate of survival of the prosthesis was 89.9% at 6.6 years (95% confidence interval).

Fig. 2

The meniscal bearing moves posteriorly as the knee is flexed fully.

Fig. 3

Dislocated bearing with deformed reduced posterior lip of an anatomic bearing.