Seven-Year Survivorship and Functional Outcomes of the High-Flexion Vanguard Complete Knee System

Schroer, William C.; Stormont, Daniel M.; Pietrzak, William S.

doi:10.1016/j.arth.2013.04.018

Cited by 18 publications

(23 citation statements)

References 34 publications

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“…Registry data show a volume threshold of 14 cases per year as an indicator of success for Oxford implants [1]. During the current study, the principal investigator, a highvolume surgeon [26], performed 83 cases with a minimum annual volume of 22 Oxford implantations during the 3 years of the study without a learning curve effect. Although a learning curve may exist beyond the first 100 cases, the majority of surgeons performing UKA would require years of ''learning'' and simply will not reach this level in time to master this surgical technique.…”

Section: Discussionmentioning

confidence: 99%

“…This study is limited because it involves a series of procedures performed by one surgeon. However, the surgeon is a high-volume knee arthroplasty subspecialist [26], was an experienced UKA surgeon at the start of the study, and performed what is considered by Baker et al [1] as a high volume of Oxford knee implants throughout the study period. Although more than 22 of these procedures were performed annually throughout the study, the Oxford knee implant was selected only for patients meeting strict eligibility criteria, representing only 7% of the surgeon's knee arthroplasty practice.…”

Section: Discussionmentioning

confidence: 99%

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The Oxford Unicompartmental Knee Fails at a High Rate in a High-volume Knee Practice

Schroer

Barnes

Diesfeld

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background The Oxford knee is a unicompartmental implant featuring a mobile-bearing polyethylene component with excellent long-term survivorship results reported by the implant developers and early adopters. By contrast, other studies have reported higher revision rates in large academic practices and in national registries. Registry data have shown increased failure with this implant especially by lower-volume surgeons and institutions. Questions/purposes In the setting of a high-volume knee arthroplasty practice, we sought to determine (1) the failure rate of the Oxford unicompartmental knee implant using a failure definition for aseptic loosening that combined clinical features, plain radiographs, and scintigraphy, and (2) whether increased experience with this implant would decrease failure rate, if there is a learning curve effect. Methods Eighty-three Oxford knee prostheses were implanted between September 2005 and July 2008 by the principal investigator. Radiographic and clinical data were available for review for all cases. A failed knee was defined as having recurrent pain after an earlier period of recovery from surgery, progressive radiolucent lines compared with initial postoperative radiographs, and a bone scan showing an isolated area of uptake limited to the area of the replaced compartment. Results Eleven knees in this series failed (13%); Kaplan-Meier survivorship was 86.5% (95% CI, 78.0%-95.0%) at 5 years. Failure occurrences were distributed evenly over the course of the study period. No learning curve effect was identified. Conclusions Based on these findings, including a high failure rate of the Oxford knee implant and the absence of any discernible learning curve effect, the principal investigator no longer uses this implant. Level of Evidence Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Oxford Unicompartmental Knee Fails at a High Rate in a High-volume Knee Practice

Schroer

Barnes

Diesfeld

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Different studies that contrasted 8,700 women knees with 5,927 men knees, both given standard implants, arrived at a similar conclusion. As of late, high-flex knees have been created to give expanded flexion potential, which is particularly helpful for high demand patients [16,19,[20][21][22]. It might be possible that gender related contrasts in results may get to be distinctly shown with the utilization of such superior prostheses, because such devices can potentially strengthen the impact of knee morphology on performance clinically.…”

Section: Discussionmentioning

confidence: 99%

“…As of late, high flex knees [20][21][22], which could mechanically accommodate even 125º of flexion (ASTM F2083) became popular; although, their capacity to support males and females alike was not set up. Just a single little intraoperative review (40 patients) and a few small (<50 patients) or intermediate cohort (138 patients) [8][9][10][11][12][13] studies have contrasted high flex knee with gender specific knee, demonstrating no clear benefit with one over another.…”

Section: Introductionmentioning

confidence: 99%

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Gender comparison of clinical outcomes post high-flex total knee arthroplasty

Hui¹,

Lu²,

Bai³

et al. 2018

biomedicalresearch

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Background: Although it is normally perceived that knee morphometry contrasts exist amongst the female as well as male populations, the literature normally disproves the need for gender specific totalknee prosthesis clinically. It was noted that standard/unisex knee performs alike or better in female than male. As of late, high flex knees became accessible, that mechanically accommodate raised flexion but not many studies have contrasted these devices' results in male and female to find out if there is any gender based contrast.

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No difference between standard and high flexion cruciate retaining total knee arthroplasty: a prospective randomised controlled study

Springorum

Maderbacher

Craiovan

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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Seven-Year Survivorship and Functional Outcomes of the High-Flexion Vanguard Complete Knee System

Cited by 18 publications

References 34 publications

The Oxford Unicompartmental Knee Fails at a High Rate in a High-volume Knee Practice

The Oxford Unicompartmental Knee Fails at a High Rate in a High-volume Knee Practice

Gender comparison of clinical outcomes post high-flex total knee arthroplasty

No difference between standard and high flexion cruciate retaining total knee arthroplasty: a prospective randomised controlled study

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