Evidence-Based Indications for Mobile-Bearing Unicompartmental Knee Arthroplasty in a Consecutive Cohort of Thousand Knees

Hamilton, Thomas W.; Pandit, Hemant; Jenkins, C.; Mellon, Stephen; Dodd, Christopher; Murray, David

doi:10.1016/j.arth.2016.12.036

Cited by 128 publications

(119 citation statements)

References 23 publications

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“…As was expected, higher rates were found in younger patients. The youngest modelled patient age was 55, and patients of this age were found to have a lifetime revision risk of 15% (CI [12][13][14][15][16][17][18][19]. This reduced to a lifetime risk of 4% (CI 3-5) for those of 85 years of age at operation.…”

Section: Discussionmentioning

confidence: 99%

Lifetime revision risk for medial unicompartmental knee replacement is lower than expected

Kennedy

Burn

Mohammad

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose Unicompartmental knee replacement (UKR) is widely considered to be a pre-total knee replacement (TKR) particularly in the young. The implication of this is that it is sensible to do a UKR, even though it will be revised at some stage, as it will delay the need for a TKR. The chance of a UKR being revised during a patient's life time has not previously been calculated. The aim of this study was to estimate this lifetime revision risks for patients of different ages undergoing UKR. Methods Calculations were based on data from a designer series of 1000 medial Oxford UKR with mean 10-year follow up. These UKR were implanted for the recommended indications using the recommended surgical technique. Parametric survival models were developed for patients of different ages based on observed data, and were extrapolated using a Markov model to estimate lifetime revision risk. Results The estimated lifetime revision risk reduced with increasing age at surgery. Lifetime revision risk at age 55 was 15% (95% CI 12-19), at 65 it was 11% (8-13), at 75 it was 7% (5-9), and at 85 it was 4% (3-5). Conclusion Provided UKR is used appropriately, the lifetime revision risk is markedly lower than expected. UKR should be considered to be a definitive knee replacement rather than a Pre-TKR even in the young. These lifetime estimates, alongside established benefits for UKR in speed of recovery, morbidity, mortality and function, can be discussed with appropriate patients when considering whether to implant a UKR or TKR. Level of evidence III.

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Section: Discussionmentioning

confidence: 99%

Lifetime revision risk for medial unicompartmental knee replacement is lower than expected

Kennedy

Burn

Mohammad

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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“…Concerning the clinical outcomes in very old patients who underwent Oxford UKA, a recent study from the Oxford center analyzed 1000 Oxford UKAs and found that at 10-year follow-up, patients younger than 60 at the time of the operation had signi cantly better American Knee Society Score Function (AKSS-F) score, Oxford Knee Score (OKS), and Tegner Activity Score than patients older than 60, but no difference in functional outcomes was seen between the groups [11]. A meta-analysis reported that the functional outcome of UKA in the elderly is good, with low rates of perioperative morbidity and mortality [12].…”

Section: Discussionmentioning

confidence: 99%

Patient Outcomes in Anteromedial Osteoarthritis Patients Over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty in China

Cheng

Feng²,

Cao

et al. 2020

Preprint

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Background: The use of Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly in both Western and Asian populations, with excellent functional outcomes and high patient satisfaction. While previous evidence regarding clinical outcomes and survival rates after Oxford UKA was based on studies in Western populations, the results may be different in Asian patients. The relevance of age for postoperative function after Oxford UKA also remains unclear. Hence, the aim of our study was to clarify the effectiveness and safety of Oxford UKA in Asian patients aged over 80 years.Methods: A retrospective review was performed and included 195 patients (209 knees) who underwent an Oxford UKA between June 2015 and July 2018. We divided the patients into three groups by age: Group 1, 60-69 years; Group 2, 70-79 years; and Group 3, over 80 years. We used the Hospital for Special Surgery (HSS) score and Western Ontario and McMaster (WOMAC) Universities Osteoarthritis Index score to evaluate the general condition of the patients’ knees before surgery and at last follow-up. We also recorded perioperative and short-term complications.Result: Group 1 consisted of 60 patients (60 knees); Group 2, 70 patients (79 knees); and Group 3, 65 patients (70 knees). The mean follow-up was 21.34 ± 12.04, 22.08 ± 11.38, and 21.76 ± 10.20 months in groups 1, 2, and 3, respectively. At last follow-up, the patients in Group 3 showed lower function scores compared to groups 1 and 2 (P <0.05), but the HSS scores and the WOMAC scores were significantly improved in all three groups. In terms of perioperative and other complications, the three age groups did not differ significantly.Conclusion: Oxford UKA is an effective and safe treatment for osteoarthritis, even in elderly patients in China. Elderly patients have lower knee function scores than younger patients. However, the knee joint pain of the elderly patients was relieved and function improved compared to the preoperative condition.

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“…Concerning the clinical outcomes in very old patients who underwent OXFORD UKA, a recent study from the Oxford center analyzed 1000 OXFORD UKAs and found that at 10-year follow-up, patients younger than 60 at the time of the operation had significantly better American Knee Society Score Function (AKSS-F) score, Oxford Knee Score (OKS), and Tegner Activity Score than patients older than 60, but no difference in categorical functional outcomes was seen between the groups [10]. A metaanalysis reported that the functional outcome of UKA in the elderly is good, with low rates of perioperative morbidity and mortality [11].…”

Section: Discussionmentioning

confidence: 99%

Curative effect and Safety in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty (UKA) in China: A Single-Center Retrospective Study

Cheng

Feng²,

et al. 2019

Preprint

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Background: Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly around the world, and the effectiveness and safety of a minimally invasive surgical approach for it demonstrate excellent outcome. Oxford UKA represents an interesting solution for older patients. The aim of our study is to evaluate the perioperative complications and short-term clinical outcome and analyze the safety for older patients who undergo Oxford UKA.Methods: A retrospective review was performed of all patients who underwent Oxford UKA between June 2015 and January 2018. We divided all patients into two groups (ages 60-80; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients' knees. We also recorded perioperative complications and long-term complications.Result:130 patients (139 knees) between the ages of 60 and 80 (Group 1) and 65 patients (70 knees) over 80 years old (Group 2) were included in the study. The mean follow-up was 22.04 ± 11.04 and 21.76 ± 10.20 months in Group 1 and 2, respectively. At last follow-up, the patients in Group 2 showed lower function scores, but both the HSS score and the WOMAC score were significantly improved in both groups after surgery. The rate of perioperative complications and other complications in elderly patients is the same as in younger patients.Conclusion: Oxford UKA showed validity and safety for elderly patients in China. The knee joint pain symptoms of the elderly patients are relieved and the function is well restored, but the function is still poor compared with the younger patients.

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Evidence-Based Indications for Mobile-Bearing Unicompartmental Knee Arthroplasty in a Consecutive Cohort of Thousand Knees

Cited by 128 publications

References 23 publications

Lifetime revision risk for medial unicompartmental knee replacement is lower than expected

Lifetime revision risk for medial unicompartmental knee replacement is lower than expected

Patient Outcomes in Anteromedial Osteoarthritis Patients Over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty in China

Curative effect and Safety in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty (UKA) in China: A Single-Center Retrospective Study

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