Reintervention after Mobile-bearing Oxford Unicompartmental Knee Arthroplasty

Abstract

BackgroundMedial compartment osteoarthritis is a common disorder that often is treated by unicompartmental knee arthroplasty (UKA). Although the Oxford 3 prosthesis is commonly used based on revision rate and cumulative survival, our experience suggests that although there may be adequate implant survival rates, we observed a worrisome and undisclosed reintervention rate of nonrevision procedures. Purpose We describe the frequency and cause of repeat intervention subsequent to implanting this device. Methods Between 1998 and 2005, 398 patients underwent UKA using the Oxford 3 prosthesis. The minimum followup was 12 months (mean, 43 months; range, 12-102 months). Results Forty of the 398 (10%) patients had 55 (13.8%) repeat anesthetics (reintervention). There were 38 nonrevision reinterventions. Revision was performed in 15 patients (3.8%), but two patients had a second revision (17 revisions or 4.3%). We revised the UKA to a second UKA in seven of the 15 cases but two subsequently were rerevised to a TKA; eight were revised directly to a TKA.

No Long-term Difference Between Fixed and Mobile Medial Unicompartmental Arthroplasty

“…Higher early minor reintervention rates for the mobile-bearing UKA were reported [7,8,11,41]. Comparative studies did not find any differences in terms of survivorship; however, the followup was limited [7,8,11,25,41]. Our goal was therefore to compare the long-term function and survivorship of fixedand mobile-bearing UKA.…”

“…Earlier studies comparing the reintervention rate [8] and the short-and midterm survivorship [9,11,41] after fixed-or mobilebearing UKA suggested a higher early minor reintervention rate for the mobile-bearing UKA [8]. However, whether the long-term function and survivorship are similar is unclear.…”

The 180° spin of meniscal bearing in unicompartmental knee arthroplasty

“…8,10,11,16 The bearing dislocation is caused by posterior impingement, ligament laxity, decreased posterior slope, and varus deformity. 6,9,17,18 Meniscal bearing dislocation has been reported in anterior, posterior, and lateral bearing locations. [10][11][12][13] In the anterior and posterior dislocation cases, since meniscal bearing can completely dislocate from the joint space, the main clinical symptoms are sudden locking, limitation of motion, acute knee pain, and swelling.…”

“…[3][4][5] But it has the potential risk of dislocation of meniscal bearing. [6][7][8][9] Symptoms caused by most meniscal bearing dislocations include acute pain, knee swelling, locking, and radiographs which can confirm the anterior, posterior, or lateral dislocation of the bearing. [10][11][12][13] However, in rare cases, it has been reported that radiologic diagnosis was delayed and confirmed late if symptoms were mild even though the liner had dislocated.…”

Unicompartmental Knee Arthroplasty: Factors Influencing the Outcome

“…19,20,22 Also, UKA has been cited to cause an increased rate of certain complications including femoral condyle fracture, tibial plateau fracture, free cement fragments, insert dislocation, and stiffness. [23][24][25][26] These findings have resulted in preference of TKA over UKA in some surgeons. 7 However, our results confirmed that UKA is a safe and effective procedure.…”