Short-term survival of cementless Oxford unicondylar knee arthroplasty based on the Finnish Arthroplasty Register

Abstract

Background: Cementless unicondylar knee arthroplasty (UKA) was introduced to secure longterm fixation and reduce the risk of revision. Experience with cementless UKA fixation is limited. Methods: The short-term survival (up to five years) of cementless Oxford UKA was assessed using data from the Finish Arthroplasty Register and was compared with that of cemented Oxford 3 UKA and total knee arthroplasty (TKA). Datawere obtained, from the Finnish Arthroplasty Register, on 1076 cementless Oxford UKAs and 2279 cemented Oxford 3 UKAs performed for primary osteoarthritis in 2005-2015. The Kaplan-Meier method, with revision for any reason as the endpoint, was used to assess the survival of these two UKA groups, and the results were compared with that of 65,563 cemented TKAs treated for primary osteoarthritis over the same period. The risk of revision of both Oxford prostheses was compared using Cox regression model, with adjustment for age and sex, with the cemented TKA group as reference. Results: The three-year survival was 93.7% for the cementless Oxford, 92.2% for the cemented Oxford 3, and 97.3% for the cemented TKA. The corresponding figures at five years were 92.3%, 88.9%, and 96.6%, respectively. The revision rate for both the cementless Oxford and the cemented Oxford 3 was significantly increased when compared with the cemented TKA (P b 0.001). Conclusions: The survival of the cementless Oxford method was higher than that of the cemented Oxford 3 in the short term. The overall survival of Oxford UKA was poor in comparison with contemporary TKAs.

Complications, Reasons for Reoperation, and 5-Year Prosthesis Survival Compared Between the Cemented and Cementless Oxford Unicompartmental Knee Arthroplasty Fixation Techniques at Thailand’s Largest National Tertiary Referral Center

“…In cementless OUKA, the most common reasons were osteoarthritis progression and infection. Our study's reoperation rate for bearing dislocation was higher than the rates from Western registry-based data (5,15). A meta-analysis by Ro,et al (16) found the mean reoperation rate per 100 observed component years for bearing dislocation after OUKA to be higher in Asians (0.53, 95% CI: 0.41-0.64) than in Westerners (0.14; 95% CI: 0.12-0.17).…”

“…However, contradictory results were reported from larger or longer-term studies. Knifsund, et al (15) collected data from the Finnish Arthroplasty Register, and they found the 5-year survival of cemented OUKA to be signi cantly shorter than that of cementless OUKA (88.9% vs. 92.3%, p<0.05). A large propensity-matched NJR-based study also showed the risk of revision in cementless OUKA to be 24% less than that of cemented OUKA within 10 years (5).…”

Functional results of total-knee arthroplasty versus medial unicompartmental arthroplasty: two-year results of a randomised, assessor-blinded multicentre trial

“…Despite the inferior survival of unicompartmental arthroplasty in registries, many orthopaedic surgeons and patients believe in the potential superior functional outcome of medial unicompartmental arthroplasty compared with total knee arthroplasty. 12 13 30 31 Given these expectations, a assessor-blind setup is the most reliable method for comparing these devices. Another strength of our study was that it was conducted in the public sector in publicly funded hospitals and the authors did not receive any grants or other funding from industry.…”

“…[8][9][10][11] Although several studies have reported good long-term results in single-centre series for medial unicompartmental knee arthroplasty, its survival has been inferior to that of total knee arthroplasty in national registries. 12 13 Therefore, whether patients should undergo unicompartmental or total knee arthroplasties at all is open to debate.…”

Comparable incidence of periprosthetic tibial fractures in cementless and cemented unicompartmental knee arthroplasty: a systematic review and meta-analysis

“…Unicompartmental knee arthroplasty (UKA) is a well-established treatment for patients with isolated compartmental knee arthritis. Advantages of UKA over total knee arthroplasty (TKA) include reduced morbidity and mortality, preservation of normal knee kinematics and faster recovery [ 35 , 49 , 59 ]. However, national registry data have shown lower revision rates after TKA in comparison to UKA [ 49 , 66 ].…”