Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 3/2017

01-03-2017 | Knee

Superior femoral component alignment can be achieved with Oxford microplasty instrumentation after minimally invasive unicompartmental knee arthroplasty

Authors: Yihui Tu, Huaming Xue, Tong Ma, Tao Wen, Tao Yang, Hui Zhang, Minwei Cai

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 3/2017

Login to get access

Abstract

Purpose

Oxford microplasty (MP) instrumentation has been developed to facilitate the reproducible and consistent performance of minimally invasive unicompartmental knee arthroplasty (MI-UKA) operation. The aim of this study was to compare the clinical and radiographic results of two groups of patients implanted using either a conventional instrumentation technique or an MP technique.

Methods

A prospective cohort study of 108 knees in 108 patients who underwent an MI-UKA procedure using either conventionally instrumented UKA (CI-UKA) (52 knees of 52 patients) or MP-assisted UKA (MP-UKA) (56 knees of 56 patients). The clinical assessment included the Oxford Knee Score (OKS), the Knee Society Score (KSS), a visual analogue scale (VAS) for pain, and range of motion (ROM). Complications were also recorded.

Results

No significant differences were observed between the two groups regarding OKS, KSS, VAS, and ROM. There were also no significant differences in terms of mechanical limb alignment and tibia implant alignment. However, the MP-UKA group showed significantly more accurate positioning of the femoral component than the CI-UKA group. Additionally, the MP-UKA group had more femoral prostheses implanted in the “satisfactory” range and fewer “outliers” than the CI-UKA group. No significant difference in complications was noted between the two groups.

Conclusion

This study suggested that compared with CI-UKA, MP-UKA provides significant improvements in increasing the accuracy of sagittal and coronal implantation of the femoral component and in reducing the numbers of outliers for femoral prosthetic alignment. It is advocated that the MP system should be considered when MI-UKA is performed.

Level of evidence

Therapeutic study, Level IV.
Literature
1.
go back to reference Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Jt Surg Br 80-B:63–69CrossRef Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement. J Bone Jt Surg Br 80-B:63–69CrossRef
2.
go back to reference Emerson RH Jr, Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL (2002) Comparison of a mobile with a fixed-bearing unicompartmental knee implant. Clin Orthop Relat Res 404:62–70CrossRef Emerson RH Jr, Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL (2002) Comparison of a mobile with a fixed-bearing unicompartmental knee implant. Clin Orthop Relat Res 404:62–70CrossRef
3.
go back to reference Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12 Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12
4.
go back to reference Faour-Martín O, Valverde-García JA, Martín-Ferrero MA, Vega-Castrillo A, de la Red Gallego MA, Suárez de Puga CC, Amigo-Liñares L (2013) Oxford phase 3 unicondylar knee arthroplasty through a minimally invasive approach: long-term results. Int Orthop 37(5):833–838CrossRefPubMedPubMedCentral Faour-Martín O, Valverde-García JA, Martín-Ferrero MA, Vega-Castrillo A, de la Red Gallego MA, Suárez de Puga CC, Amigo-Liñares L (2013) Oxford phase 3 unicondylar knee arthroplasty through a minimally invasive approach: long-term results. Int Orthop 37(5):833–838CrossRefPubMedPubMedCentral
5.
go back to reference Fisher DA, Watts M, Davis KE (2003) Implant position in knee surgery: a comparison of minimally invasive, open unicompartmental, and total knee arthroplasty. J Arthroplast 18(7 Suppl 1):2–8CrossRef Fisher DA, Watts M, Davis KE (2003) Implant position in knee surgery: a comparison of minimally invasive, open unicompartmental, and total knee arthroplasty. J Arthroplast 18(7 Suppl 1):2–8CrossRef
6.
go back to reference Gulati A, Weston-Simons S, Evans D, Jenkins C, Gray H, Dodd CA, Pandit H, Murray DW (2014) Radiographic evaluation of factors affecting bearing dislocation in the domed lateral Oxford unicompartmental knee replacement. Knee 21(6):1254–1257CrossRefPubMed Gulati A, Weston-Simons S, Evans D, Jenkins C, Gray H, Dodd CA, Pandit H, Murray DW (2014) Radiographic evaluation of factors affecting bearing dislocation in the domed lateral Oxford unicompartmental knee replacement. Knee 21(6):1254–1257CrossRefPubMed
7.
go back to reference Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165CrossRef Hernigou P, Deschamps G (2004) Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res 423:161–165CrossRef
8.
go back to reference Huang TW, Peng KT, Huang KC, Lee MS, Hsu RW (2014) Differences in component and limb alignment between computer-assisted and conventional surgery total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22(12):2954–2961CrossRefPubMed Huang TW, Peng KT, Huang KC, Lee MS, Hsu RW (2014) Differences in component and limb alignment between computer-assisted and conventional surgery total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22(12):2954–2961CrossRefPubMed
9.
go back to reference Keene G, Simpson D, Kalairajah Y (2006) Limb alignment in computer-assisted minimally-invasive unicompartmental knee replacement. J Bone Jt Surg Br 88:44–48CrossRef Keene G, Simpson D, Kalairajah Y (2006) Limb alignment in computer-assisted minimally-invasive unicompartmental knee replacement. J Bone Jt Surg Br 88:44–48CrossRef
10.
go back to reference Kort NP, van Raay JJ, Cheung J, Jolink C, Deutman R (2007) Analysis of Oxford medial unicompartmental knee replacement using the minimally invasive technique in patients aged 60 and above: an independent prospective series. Knee Surg Sports Traumatol Arthrosc 15(11):1331–1334CrossRefPubMedPubMedCentral Kort NP, van Raay JJ, Cheung J, Jolink C, Deutman R (2007) Analysis of Oxford medial unicompartmental knee replacement using the minimally invasive technique in patients aged 60 and above: an independent prospective series. Knee Surg Sports Traumatol Arthrosc 15(11):1331–1334CrossRefPubMedPubMedCentral
11.
go back to reference Kort NP, van Raay JJ, Thomassen BJ (2007) Alignment of the femoral component in a mobile-bearing unicompartmental knee arthroplasty: a study in 10 cadaver femora. Knee 14:280–283CrossRefPubMed Kort NP, van Raay JJ, Thomassen BJ (2007) Alignment of the femoral component in a mobile-bearing unicompartmental knee arthroplasty: a study in 10 cadaver femora. Knee 14:280–283CrossRefPubMed
12.
go back to reference Lim HC, Bae JH, Song SH, Kim SJ (2012) Oxford phase 3 unicompartmental knee replacement in Korean patients. J Bone Jt Surg Br 94(8):1071–1076CrossRef Lim HC, Bae JH, Song SH, Kim SJ (2012) Oxford phase 3 unicompartmental knee replacement in Korean patients. J Bone Jt Surg Br 94(8):1071–1076CrossRef
13.
go back to reference Ma B, Long W, Rudan JF, Ellis RE (2006) Three-dimensional analysis of alignment error in using femoral intramedullary guides in unicompartmental knee arthroplasty. J Arthroplasty 21(2):271–278CrossRefPubMed Ma B, Long W, Rudan JF, Ellis RE (2006) Three-dimensional analysis of alignment error in using femoral intramedullary guides in unicompartmental knee arthroplasty. J Arthroplasty 21(2):271–278CrossRefPubMed
14.
go back to reference Mayman DJ, Rudan J, Watson D, Ellis R (2004) Computer-enhanced insertion of the Oxford unicompartmental arthroplasty: a fluoroguide technique. Comput Aided Surg 9:81–85CrossRefPubMed Mayman DJ, Rudan J, Watson D, Ellis R (2004) Computer-enhanced insertion of the Oxford unicompartmental arthroplasty: a fluoroguide technique. Comput Aided Surg 9:81–85CrossRefPubMed
15.
go back to reference Murray DW, Goodfellow JW, O’Connor JJ (1998) The Oxford medial unicompartmental arthroplasty: a ten year survival study. J Bone Jt Surg Br 80:983–989CrossRef Murray DW, Goodfellow JW, O’Connor JJ (1998) The Oxford medial unicompartmental arthroplasty: a ten year survival study. J Bone Jt Surg Br 80:983–989CrossRef
16.
go back to reference Murray DW, Goodfellow JW, O’Connor JJ, Dodd CA (1999) Oxford unicompartmental knee: manual of the surgical technique. Biomet UK Ltd, Bridgend, pp 1–40 Murray DW, Goodfellow JW, O’Connor JJ, Dodd CA (1999) Oxford unicompartmental knee: manual of the surgical technique. Biomet UK Ltd, Bridgend, pp 1–40
17.
go back to reference Pandit H, Jenkins C, Barker K, Dodd CA, Murray DW (2006) The Oxford medial unicompartmental knee replacement using a minimally-invasive approach. J Bone Jt Surg Br 88(1):54–60CrossRef Pandit H, Jenkins C, Barker K, Dodd CA, Murray DW (2006) The Oxford medial unicompartmental knee replacement using a minimally-invasive approach. J Bone Jt Surg Br 88(1):54–60CrossRef
18.
go back to reference Rosenberger RE, Fink C, Quirbach S, Attal R, Tecklenburg K, Hoser C (2008) The immediate effect of navigation on implant accuracy in primary mini-invasive unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 16:1133–1140CrossRefPubMed Rosenberger RE, Fink C, Quirbach S, Attal R, Tecklenburg K, Hoser C (2008) The immediate effect of navigation on implant accuracy in primary mini-invasive unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 16:1133–1140CrossRefPubMed
19.
go back to reference Skowroński J, Jatskewych J, Długosz J, Skowroński R, Bielecki M (2005) The Oxford II medial unicompartmental knee replacement. A minimum 10-year follow-up study. Ortop Traumatol Rehabil 7(6):620–625PubMed Skowroński J, Jatskewych J, Długosz J, Skowroński R, Bielecki M (2005) The Oxford II medial unicompartmental knee replacement. A minimum 10-year follow-up study. Ortop Traumatol Rehabil 7(6):620–625PubMed
20.
go back to reference Stulberg SD, Loan P, Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Jt Surg Am 84:90–98CrossRef Stulberg SD, Loan P, Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Jt Surg Am 84:90–98CrossRef
21.
go back to reference Svärd VC, Price AJ (2001) Oxford medial unicompartmental arthroplasty: a survival analysis of an independent series. J Bone Jt Surg Br 83:191–194CrossRef Svärd VC, Price AJ (2001) Oxford medial unicompartmental arthroplasty: a survival analysis of an independent series. J Bone Jt Surg Br 83:191–194CrossRef
22.
go back to reference Tu Y, Xue H, Cai M, Ma T, Liu X, Xia Z (2014) Improvement of femoral component size prediction using a C-arm intensifier guide and our established algorithm in unicompartmental knee arthroplasty: a report from a Chinese population. Knee 21(2):435–438CrossRefPubMed Tu Y, Xue H, Cai M, Ma T, Liu X, Xia Z (2014) Improvement of femoral component size prediction using a C-arm intensifier guide and our established algorithm in unicompartmental knee arthroplasty: a report from a Chinese population. Knee 21(2):435–438CrossRefPubMed
23.
go back to reference Vasso M, Del Regno C, D’Amelio A, Viggiano D, Corona K, Schiavone Panni A (2015) Minor varus alignment provides better results than neutral alignment in medial UKA. Knee 22(2):117–121CrossRefPubMed Vasso M, Del Regno C, D’Amelio A, Viggiano D, Corona K, Schiavone Panni A (2015) Minor varus alignment provides better results than neutral alignment in medial UKA. Knee 22(2):117–121CrossRefPubMed
24.
go back to reference Yoshida K, Tada M, Yoshida H, Takei S, Fukuoka S, Nakamura H (2013) Oxford phase 3 unicompartmental knee arthroplasty in Japan—clinical results in greater than one thousand cases over ten years. J Arthroplasty 28(9 Suppl):168–171CrossRefPubMed Yoshida K, Tada M, Yoshida H, Takei S, Fukuoka S, Nakamura H (2013) Oxford phase 3 unicompartmental knee arthroplasty in Japan—clinical results in greater than one thousand cases over ten years. J Arthroplasty 28(9 Suppl):168–171CrossRefPubMed
Metadata
Title
Superior femoral component alignment can be achieved with Oxford microplasty instrumentation after minimally invasive unicompartmental knee arthroplasty
Authors
Yihui Tu
Huaming Xue
Tong Ma
Tao Wen
Tao Yang
Hui Zhang
Minwei Cai
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 3/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-016-4173-3

Other articles of this Issue 3/2017

Knee Surgery, Sports Traumatology, Arthroscopy 3/2017 Go to the issue