A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

Janssen, Stein J.; Oost, Iris van; Breugem, Stefan J. M.; Geenen, Rutger C. I. van

doi:10.1302/2058-5241.6.200105

Cited by 7 publications

(5 citation statements)

References 109 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Common causes for bearing failure following UKA comprise malpositioning of the component, inadequate size of the insert, residual ligamental laxity, knee deformities or wear. 4 Traumatic injuries can lead to bearing dislocation or in rare cases, to breakage of the component. In a report by Lim et al., a worn Oxford III meniscal bearing fractured 7 years after primary surgery as a result of significant wear and was replaced with a thicker bearing.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopically-assisted retrieval of a fractured polyethylene Oxford knee meniscal bearing: a case report

2023

View full text Add to dashboard Cite

Fracture of a polyethylene insert in a knee prosthesis is an uncommon but severe complication resulting in an unstable and malfunctioning knee that requires revision surgery. The aim of this paper was to present our experience with a minimally-invasive option for retrieving a posteriorly-migrated fragment of a mobile tibial bearing, which is a rare complication. We describe the management of a case of breakage of an Oxford knee medial bearing. Half of the mobile bearing was retrieved from the suprapatellar recess, while the other half had migrated posteriorly to the femoral condyle and was retrieved through an arthroscopically-assisted approach with the help of a posteromedial port. At the follow-up, no further complaints were reported by the patient, and activities of daily living were possible without pain or limitations. This report of a breakage of the mobile bearing following Oxford knee medial prosthesis placement demonstrates that in the event of breakage of the bearing, an arthroscopically-assisted approach is safe in the removal of the bearing and allows its replacement.

show abstract

Section: Discussionmentioning

confidence: 99%

Arthroscopically-assisted retrieval of a fractured polyethylene Oxford knee meniscal bearing: a case report

2023

View full text Add to dashboard Cite

show abstract

“…Surgeons aim to use thin bearings (either 3.5 mm-Size 3 or 4.5 mm-Size 4) with the OUKR to make a conservative tibial resection. Despite the use of thin bearings wear is a rare cause of failure for the OUKR [1]. Excessive linear wear can result in bearing fracture in the long-term, however this complication can easily be treated by inserting a new bearing [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Polyethylene bearing wear is comparable for cemented and cementless Oxford unicompartmental knee replacements: Ten‐year results of a randomized controlled trial

Arthur,

Ghosh,

Mohammad

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeThere is concern that using cementless components may increase polyethylene wear of the Oxford unicompartmental knee replacement (OUKR). Therefore, this study aimed to measure bearing wear at 10 years in patients from a randomized trial comparing Phase 3 cemented and cementless OUKRs and to investigate factors that may affect wear. It was hypothesized that there would be no difference in wear rate between cemented and cementless OUKRs.MethodsBearing thickness was determined using radiostereometric analysis at postoperative, 3‐month, 6‐month, 1‐year, 2‐year, 5‐year and 10‐year timepoints. As creep occurs early, wear rate was calculated using linear regression between 6 months and 10 years for 39 knees (20 cemented, 19 cementless). Associations between wear and implant, surgical and patient factors were analysed.ResultsThe linear wear rate of the Phase 3 OUKR was 0.06 mm/year with no significant difference (p = 0.18) between cemented (0.054 mm/year) and cementless (0.063 mm/year) implants. Age, Oxford Knee Score, component size and bearing thickness had no correlation with wear. A body mass index ≥ 30 was associated with a significantly lower wear rate (p = 0.007) as was having ≥80% femoral component contact area on the bearing (p = 0.003). Bearings positioned ≥1.5 mm from the tibial wall had a significantly higher wear rate (p = 0.002).ConclusionsAt 10 years, the Phase 3 OUKR linear wear rate is low and not associated with the fixation method. To minimize the risk of wear‐related bearing fracture in the very long‐term surgeons should consider using 4 mm bearings in very young active patients and ensure that components are appropriately positioned, which is facilitated by the current instrumentation.Level of EvidenceLevel III, Retrospective Comparative Study.

show abstract

“…4 Knee alignment after UKA is critical to prevent complications such as KOA progression and early loosening and is a determinant of UKA longevity. [5][6][7] Postoperative knee alignment is also the most important factor that the surgeon can control and modify. A number of studies have demonstrated the correlation between postoperative knee alignment and clinical outcomes and UKA survival.…”

Section: Introductionmentioning

confidence: 99%

“…Knee alignment after UKA is critical to prevent complications such as KOA progression and early loosening and is a determinant of UKA longevity 5–7 . Postoperative knee alignment is also the most important factor that the surgeon can control and modify.…”

Section: Introductionmentioning

confidence: 99%

Valgus Stress Radiograph Can Predict Alignment Change of Medial Mobile‐Bearing Unicompartmental Knee Arthroplasty

Jiao

et al. 2023

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective Finding reliable tools to predict alignment change after medial mobile‐bearing unicompartmental knee arthroplasty (UKA) can help surgeons avoid under‐ or over‐correction. This prospective study aimed to investigate whether the parameters related to medial collateral ligament tension on valgus stress radiograph can predict the alignment change of medial mobile‐bearing UKA and establish a prediction model. Methods This study prospectively included the patients undergoing medial mobile‐bearing UKA for knee osteoarthritis from November 2018 and April 2021. Patients took valgus stress radiograph and MRI preoperatively and took full‐length weight‐bearing anterior–posterior radiograph of the lower extremity preoperatively and postoperatively. The medial joint space width (MJSW) on valgus stress radiograph, area of femoral and tibial osteophyte on MRI, medial extrusion distance (MED) of the meniscus on MRI, and the change in hip‐knee‐ankle angle (∆HKAA) were measured. Factors influencing ∆HKAA were analyzed by correlation analysis. Univariable and multivariable linear regression analysis was performed to establish a prediction model of ∆HKAA. Results One hundred and seven knees were included. On average, the preoperative HKAA was 170.84° ± 3.73°, and UKA corrected the alignment to 175.16° ± 3.21° postoperatively (p < 0.001), with ∆HKAA of 4.33° ± 1.93°. Correlation analysis showed that ∆HKAA correlated with MJSW (r = 0.628, p < 0.001), MED (r = 0.262, p < 0.001), and tibial osteophyte area (r = 0.235, p < 0.001). The prediction model for ∆HKAA was obtained by multivariable linear regression: ∆HKAA = −2.003 + 0.947 × MJSW(mm) + 1.838 × total osteophyte area(cm2). Conclusion Valgus stress radiographic MJSW and osteophyte area are correlated to the alignment change of medial mobile‐bearing UKA. The prediction model for HKAA change is: ∆HKAA = −2.003 + 0.947 × MJSW(mm) + 1.838 × total osteophyte area(cm2).

show abstract

A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

Cited by 7 publications

References 109 publications

Arthroscopically-assisted retrieval of a fractured polyethylene Oxford knee meniscal bearing: a case report

Arthroscopically-assisted retrieval of a fractured polyethylene Oxford knee meniscal bearing: a case report

Polyethylene bearing wear is comparable for cemented and cementless Oxford unicompartmental knee replacements: Ten‐year results of a randomized controlled trial

Valgus Stress Radiograph Can Predict Alignment Change of Medial Mobile‐Bearing Unicompartmental Knee Arthroplasty

Contact Info

Product

Resources

About