PurposeIn the last decade, a major increase in the use of and interest in unicompartmental knee arthroplasty (UKA) has developed. The Oxford Phase 3 UKA is implanted with a minimally invasive technique using newly developed instruments. The objective of this prospective study was to evaluate the outcome of UKA in patients with medial osteoarthritis of the knee in a high-volume unit.MethodsTwo-hundred and forty-four UKAs were performed with a minimally invasive approach. The median age was 72 (43–91) years. The median follow-up was 4.2 years (range 1–10.4 years). Fourteen patients died, and nine were considered to be lost to follow-up, but all had a well-functioning prosthesis in situ until their last follow-up. Pain, function and health-related quality of life were evaluated pre- and postoperatively using patient- and assessor-based outcome scores, as well as radiographic evidence.ResultsThe mean Knee Society knee and function scores, WOMAC-scores, Oxford-score and VAS pain and satisfaction all improved. Nine knees required revision. Eleven patients required an additional arthroscopic procedure due to persisting pain secondary to intra-articular pathology, and four patients required manipulation under anaesthesia because of limited range of motion. The 7-year cumulative survival rate of the arthroplasty was 94.4%. A low incidence (21%) of a radiolucent line beneath the tibial component was observed at 5 years of follow-up.ConclusionThis study showed a high survival rate of the Oxford Phase 3 UKA. Patient satisfaction and functional performance were also very high. Major complication rate was low; in addition, the incidence of radiolucency under the tibial component, when compared to present literature, was low. When strict indication criteria are followed, excellent, durable, and in our opinion reliable, results can be expected for this procedure.
AimsThe interest in unicompartmental knee arthroplasty (UKA) for
medial osteoarthritis has increased rapidly but the long-term follow-up
of the Oxford UKAs has yet to be analysed in non-designer centres.
We have examined our ten- to 15-year clinical and radiological follow-up
data for the Oxford Phase III UKAs.Patients and MethodsBetween January 1999 and January 2005 a total of 138 consecutive
Oxford Phase III arthroplasties were performed by a single surgeon
in 129 patients for medial compartment osteoarthritis (71 right
and 67 left knees, mean age 72.0 years (47 to 91), mean body mass
index 28.2 (20.7 to 52.2)). Both clinical data and radiographs were
prospectively recorded and obtained at intervals. Of the 129 patients,
32 patients (32 knees) died, ten patients (12 knees) were not able
to take part in the final clinical and radiological assessment due
to physical and mental conditions, but via telephone interview it
was confirmed that none of these ten patients (12 knees) had a revision
of the knee arthroplasty. One patient (two knees) was lost to follow-up.ResultsThe mean follow-up was 11.7 years (10 to 15). A total of 11 knees
(8%) were revised. The survival at 15 years with revision for any
reason as the endpoint was 90.6% (95% confidence interval (CI) 85.2
to 96.0) and revision related to the prosthesis was 99.3% (95% CI
97.9 to 100). The mean total Knee Society Score was 47 (0 to 80)
pre-operatively and 81 (30 to 100) at latest follow-up. The mean
Oxford Knee Score was 19 (12 to 40) pre-operatively and 42 (28 to 55)
at final follow-up. Radiolucency beneath the tibial component occurred
in 22 of 81 prostheses (27.2%) without evidence of loosening.ConclusionThis study supports the use of UKA in medial compartment osteoarthritis
with excellent long-term functional and radiological outcomes with
an excellent 15-year survival rate.Cite this article: Bone Joint J 2016;98-B(10
Suppl B):41–7.
Oral administration of 2 mg/kg grapiprant in fed and fasted dogs resulted in different pharmacokinetics of the drug, but did not influence the length of time when concentrations in plasma exceeded theoretical effective concentrations. Further studies are necessary to verify these findings using pharmacokinetic-pharmacodynamic studies and in clinical subjects.
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