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Published in: Journal of Orthopaedic Surgery and Research 1/2011

Open Access 01-12-2011 | Research article

Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term

Authors: Mark C Edmondson, David Isaac, Malin Wijeratna, Sean Brink, Paul Gibb, Paul Skinner

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2011

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Abstract

Background

In our experience results of the Oxford unicompartmental knee replacement have not been as good as had been expected. A common post operative complaint is of persistent medial knee discomfort, it is not clear why this phenomenon occurs and we have attempted to address this in our study.

Methods

48 patients were retrospectively identified at a mean of 4.5 years (range = 3 to 6 years) following consecutive Oxford medial Unicompartmental Knee arthroplasties for varus anteromedial osteoarthritis. The mean age at implantation was 67 years (range 57-86). Of these 48 patients, 4 had died, 4 had undergone revision of their unicompartmental knee replacements and 2 had been lost to follow up leaving 38 patients with 40 replaced knees available for analysis using the 'new Oxford Knee Score' questionnaire. During assessment patients were asked specifically whether or not they still experienced medial knee discomfort or pain.

Results

The mean 'Oxford score' was only 32.7 (range = 16 to 48) and 22 of the 40 knees were uncomfortable or painful medially.
The accuracy of component positioning was recorded, using standard post operative xrays, by summing the angulation or displacement of each component in two planes from the ideal position (according to the 'Oxford knee system radiographic criteria'). No correlation was demonstrated between the radiographic scores and the 'Oxford scores', or with the presence or absence of medial knee discomfort or pain.

Conclusion

In our hands the functional outcome following Oxford Unicompartmental knee replacement was variable, with a high incidence of medial knee discomfort which did not correlate with the postoperative radiographic scores, pre-op arthritis and positioning of the prosthesis.
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Literature
1.
go back to reference Murray DW, Goodfellow JW, O'Connor JJ: The Oxford medial unicompartmental arthroplasty: a ten year survival study. Journal of Bone and Joint surgery (B). 1998, 80 (6): 983-9. 10.1302/0301-620X.80B6.8177.CrossRef Murray DW, Goodfellow JW, O'Connor JJ: The Oxford medial unicompartmental arthroplasty: a ten year survival study. Journal of Bone and Joint surgery (B). 1998, 80 (6): 983-9. 10.1302/0301-620X.80B6.8177.CrossRef
2.
go back to reference Keys GW, Ul-Abbiddin Z, Toh EM: Analysis of first forty Oxford medial unicompartmental knee replacement from a small district general hospital in UK. Knee. 2004, 11 (5): 375-7. 10.1016/j.knee.2004.03.007.CrossRefPubMed Keys GW, Ul-Abbiddin Z, Toh EM: Analysis of first forty Oxford medial unicompartmental knee replacement from a small district general hospital in UK. Knee. 2004, 11 (5): 375-7. 10.1016/j.knee.2004.03.007.CrossRefPubMed
3.
go back to reference Rajasekhar C, Das S, Smith A: Unicompartmental knee arthroplasty 2-12 year results in a community hospital. Journal of Bone and Joint surgery (B). 2004, 86 (7): 983-5. 10.1302/0301-620X.86B7.15157.CrossRef Rajasekhar C, Das S, Smith A: Unicompartmental knee arthroplasty 2-12 year results in a community hospital. Journal of Bone and Joint surgery (B). 2004, 86 (7): 983-5. 10.1302/0301-620X.86B7.15157.CrossRef
4.
go back to reference Svard UC, Price AJ: Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. Journal of Bone and Joint surgery (B). 2001, 83 (2): 191-4. 10.1302/0301-620X.83B2.10966.CrossRef Svard UC, Price AJ: Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. Journal of Bone and Joint surgery (B). 2001, 83 (2): 191-4. 10.1302/0301-620X.83B2.10966.CrossRef
5.
go back to reference Verdonk R, Cottenie D, Almqvist KF, Vorlat P: The Oxford unicompartmental knee prosthesis: a 2-14 year follow-up. Knee Surg Sports Traumatol Arthros. 2005, 13: 163-166. 10.1007/s00167-004-0522-8.CrossRef Verdonk R, Cottenie D, Almqvist KF, Vorlat P: The Oxford unicompartmental knee prosthesis: a 2-14 year follow-up. Knee Surg Sports Traumatol Arthros. 2005, 13: 163-166. 10.1007/s00167-004-0522-8.CrossRef
6.
go back to reference Newman J, Pydissiti R, Ackroyd C: Unicompartmental or total knee replacement. The 15 year results of a prospective randomised controlled trial. Journal of Bone and Joint Surgery. 2009, 91-B (1): 52-57. 10.1302/0301-620X.91B1.20899.CrossRef Newman J, Pydissiti R, Ackroyd C: Unicompartmental or total knee replacement. The 15 year results of a prospective randomised controlled trial. Journal of Bone and Joint Surgery. 2009, 91-B (1): 52-57. 10.1302/0301-620X.91B1.20899.CrossRef
7.
go back to reference Volpin G, Schachar R, Shtarkjer H: Functional outcome after unicompartmental knee arthroplasty in patients with osteoarthritis of the medial compartment. Journal of Bone and Joint Surgery. 2006, 88-B (SUPP_II): 335- Volpin G, Schachar R, Shtarkjer H: Functional outcome after unicompartmental knee arthroplasty in patients with osteoarthritis of the medial compartment. Journal of Bone and Joint Surgery. 2006, 88-B (SUPP_II): 335-
8.
go back to reference Van Isacker T, Cottenie D, Vorlat P, Verdonk R: The oxford unicompartmental knee replacement an independent 10 year follow up. Journal of Bone and Joint Surgery. 2004, 86-B (SUPP_III): 290- Van Isacker T, Cottenie D, Vorlat P, Verdonk R: The oxford unicompartmental knee replacement an independent 10 year follow up. Journal of Bone and Joint Surgery. 2004, 86-B (SUPP_III): 290-
9.
go back to reference Cottenie Dominique, Vorlat P, Byn P, Almqvist KF, Verdonk R: The oxford unicompartmental knee replacement a 2-14 year follow up. Journal of Bone and Joint Surgery. 2004, 86-B (SUPP_III): 308- Cottenie Dominique, Vorlat P, Byn P, Almqvist KF, Verdonk R: The oxford unicompartmental knee replacement a 2-14 year follow up. Journal of Bone and Joint Surgery. 2004, 86-B (SUPP_III): 308-
10.
go back to reference Kim KT, Lee S, Park H, Cho K, Kim K: A Prospective Analysis of Oxford Phase 3 Unicompartmental Knee Arthroplasty. Orthopedics. 2007, 30 (5): 15-18.PubMed Kim KT, Lee S, Park H, Cho K, Kim K: A Prospective Analysis of Oxford Phase 3 Unicompartmental Knee Arthroplasty. Orthopedics. 2007, 30 (5): 15-18.PubMed
12.
go back to reference Chana R, Shenava Y, Nicholl A, Lusted F, Skinner P, Gibb P: Five to 8 year results of the uncemented Duracon total knee arthroplasty system. The Journal of Arthroplasty. 2008, 23 (5): 677-682. 10.1016/j.arth.2007.06.002.CrossRefPubMed Chana R, Shenava Y, Nicholl A, Lusted F, Skinner P, Gibb P: Five to 8 year results of the uncemented Duracon total knee arthroplasty system. The Journal of Arthroplasty. 2008, 23 (5): 677-682. 10.1016/j.arth.2007.06.002.CrossRefPubMed
13.
go back to reference White SH, Goodfellow JW, O'connor JJ: Anteromedial Osteoarthritis of the Knee. Journal of Bone and Joint Surgery (Br). 1991, 582-86. 73-8 White SH, Goodfellow JW, O'connor JJ: Anteromedial Osteoarthritis of the Knee. Journal of Bone and Joint Surgery (Br). 1991, 582-86. 73-8
14.
go back to reference Dawson J, Fitzpatrick R, Murray D, Carr A: Questionnaire on the perceptions of patients about total knee replacement. Journal of Bone Joint Surgery (Br). 1998, 80 (1): 63-9. 10.1302/0301-620X.80B1.7859.CrossRef Dawson J, Fitzpatrick R, Murray D, Carr A: Questionnaire on the perceptions of patients about total knee replacement. Journal of Bone Joint Surgery (Br). 1998, 80 (1): 63-9. 10.1302/0301-620X.80B1.7859.CrossRef
15.
go back to reference Cohen J: Statistical power analysis for the behavioral sciences (2nd ed.). 1988, Hillsdale, NJ: Lawrence Erlbaum Associates, ISBN 0-8058-0283-5 Cohen J: Statistical power analysis for the behavioral sciences (2nd ed.). 1988, Hillsdale, NJ: Lawrence Erlbaum Associates, ISBN 0-8058-0283-5
16.
go back to reference Cartier P, Sanouiller JL, Greisamer RP: The Oxford Unicompartmental, Arthroplasty - a ten year survival study. Journal of Bone and Joint Surgery(Br). 1998, 983-9. 80-B Cartier P, Sanouiller JL, Greisamer RP: The Oxford Unicompartmental, Arthroplasty - a ten year survival study. Journal of Bone and Joint Surgery(Br). 1998, 983-9. 80-B
17.
go back to reference Palacious BF, Montes SF: Unicompartmental knee arthroplasty with an Oxford prosthesis. Acta Ortop Mex. 2007, 21 (2): 49-54. Palacious BF, Montes SF: Unicompartmental knee arthroplasty with an Oxford prosthesis. Acta Ortop Mex. 2007, 21 (2): 49-54.
18.
go back to reference Robertson O, Knutson K, Lewold S, Lidgren L: The routine of surgical management reduces failure after unicompartmental knee implant. Journal of Bone and Joint Surgery. 2001, 45-9. 83B Robertson O, Knutson K, Lewold S, Lidgren L: The routine of surgical management reduces failure after unicompartmental knee implant. Journal of Bone and Joint Surgery. 2001, 45-9. 83B
19.
go back to reference Emerson RH, Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL: Comparison of mobile and fixed bearing unicompartmental knee implant. Clinical Orthopaedics. 2002, 404: 62-70.CrossRef Emerson RH, Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL: Comparison of mobile and fixed bearing unicompartmental knee implant. Clinical Orthopaedics. 2002, 404: 62-70.CrossRef
20.
go back to reference The KAT trial group: The knee arthroplasty trial Design features, Baseline characteristics and two year functional outcomes after alternative approaches to knee replacement. J Bone Joint Surg Am. 2009, 91: 134-141. The KAT trial group: The knee arthroplasty trial Design features, Baseline characteristics and two year functional outcomes after alternative approaches to knee replacement. J Bone Joint Surg Am. 2009, 91: 134-141.
21.
go back to reference Gulati A, Chua R, Simpson DJ, Dodd CAF, Murray DW: Influence of component alignment on Unicompartmental Knee replacement. The Knee. 2009, 16 (3): 196-199. 10.1016/j.knee.2008.11.001.CrossRefPubMed Gulati A, Chua R, Simpson DJ, Dodd CAF, Murray DW: Influence of component alignment on Unicompartmental Knee replacement. The Knee. 2009, 16 (3): 196-199. 10.1016/j.knee.2008.11.001.CrossRefPubMed
22.
go back to reference Murray D, Simpson D, Dodd C, Gill H, Beard D, Pandit H, Chau R: An acceptable limit of tibial component overhang in the Oxford unicompartmental knee arthroplasty. British Association for Surgery of the Knee, free paper session 'Technical aspects of UKA', Bournemouth. 2008 Murray D, Simpson D, Dodd C, Gill H, Beard D, Pandit H, Chau R: An acceptable limit of tibial component overhang in the Oxford unicompartmental knee arthroplasty. British Association for Surgery of the Knee, free paper session 'Technical aspects of UKA', Bournemouth. 2008
23.
go back to reference Gleeson RE, Evans R, Ackroyd CE, Webb J, Newman J: Fixed or mobile bearing unicompartmental knee replacement? A comparative cohort study. The Knee. 2004, 11: 379-384. 10.1016/j.knee.2004.06.006.CrossRefPubMed Gleeson RE, Evans R, Ackroyd CE, Webb J, Newman J: Fixed or mobile bearing unicompartmental knee replacement? A comparative cohort study. The Knee. 2004, 11: 379-384. 10.1016/j.knee.2004.06.006.CrossRefPubMed
24.
go back to reference Murray D: Mobile bearing Unicompartmental knee replacement. Orthopaedics. 2005, 28 (9): 985-87. Murray D: Mobile bearing Unicompartmental knee replacement. Orthopaedics. 2005, 28 (9): 985-87.
25.
go back to reference Kasodekar VB, Yeo SJ, Othman S: Clinical outcome of unicompartmental knee arthroplasty and influence of alignment on prosthesis survival rate. Singapore Medical Journal. 2006, 47 (9): 796-802.PubMed Kasodekar VB, Yeo SJ, Othman S: Clinical outcome of unicompartmental knee arthroplasty and influence of alignment on prosthesis survival rate. Singapore Medical Journal. 2006, 47 (9): 796-802.PubMed
26.
go back to reference Tregonning R, Rothwell A, Hobbs T, Hartnett N: Early failure of the Oxford phase 3 cemented medial uni-compartmental knee joint arthroplasty. J Bone Joint Surg Br. 2009, 91-B (Supp II): 339- Tregonning R, Rothwell A, Hobbs T, Hartnett N: Early failure of the Oxford phase 3 cemented medial uni-compartmental knee joint arthroplasty. J Bone Joint Surg Br. 2009, 91-B (Supp II): 339-
Metadata
Title
Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term
Authors
Mark C Edmondson
David Isaac
Malin Wijeratna
Sean Brink
Paul Gibb
Paul Skinner
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2011
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/1749-799X-6-52

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