The Oxford unicompartmental knee arthroplasty: a radiological perspective

Mukherjee, Kausik; Pandit, Hemant; Dodd, Christopher; Ostlere, S; Murray, David

doi:10.1016/j.crad.2007.12.017

Cited by 35 publications

(23 citation statements)

References 8 publications

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“…Although a 27-year Finnish registry study has shown a lower survivorship of different UKAs in comparison to total knee arthroplasty survivorship, the medial Oxford UKA has documented very good medium and long-term clinical results with survival rates of 91 % after 20 years [10]. The classic indication for a UKA with the Oxford system is anteromedial osteoarthritis [11] presented with full thickness cartilage loss and bone on bone in the preoperative stress or standing radiographs [12,13]. In clinical practice, there are some mid-aged patients with appropriate clinical symptoms (anteromedial pain; ''one-finger-sign'') but only PTCL (partial thickness cartilage loss).…”

Section: Discussionmentioning

confidence: 99%

Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL

Maier

Kuhs

Streit

et al. 2015

Arch Orthop Trauma Surg

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Section: Discussionmentioning

confidence: 99%

Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL

Maier

Kuhs

Streit

et al. 2015

Arch Orthop Trauma Surg

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“…Several authors' opinion is that the reason for failures is component malalignment such as varus-valgus component malalignment (3,10,11), more than 6 degrees of intraprosthetic divergence, more than 3 degrees of change in tibial component's obliquity and 2 degrees of cange of TS (4). Chatellard (4) reported that more than 2 mm of prosthetic joint space elevation or depression and more than 5 degrees of residual varus deformity both lead to mechanical failure.…”

Section: Discussionmentioning

confidence: 99%

“…Several articles have been published about the range of acceptable components' malalignment (3)(4)(5)(6)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

Medial Unicompartmental Knee Arthroplasty: Correlation Between Components’ Malalignment and Long-term Outcome in Obese Patients

Zsakai¹,

Nadianmehr²,

Oláh³

et al. 2017

Trauma Mon

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Background: The (UKA) is performed as an alternative to total knee arthroplasty (TKA) and high tibial osteotomy for unicompartmental osteoarthritis. Objectives: We examined whether the tolerable range of component malalignment is narrower in obese (BMI > 30) than in nonobese patients. Methods: We performed 163 consecutive all-poly medial UKA from 01/01/1995 to 31/10/2003. We examined 83 patients (88 knees) at a minimal follow-up period of 10 years. We examined the correlation between limb-and component malalignment and clinical outcome separately in the obese (67 knees) and nonobese (21 knees) group. Results: The 10-year prothesis survival was 92.8%, and 9 UKA were converted to total knee arthroplasty. The average time to revision was 84.44 (48 to 144) months. The 8 obese and 1 nonobese patients had slightly higher BMI (33.47) than the 83 long-term followed patients (31.72). In each of these 9 patients, knee score and functional score were poor. At every revision, we used stems and augments. In the obese group, the prosthetic joint space depression correlated with fair and poor knee and functional scores, the prosthetic joint space elevation is correlated with degenerative changes in lateral tibiofemoral joint. Conclusions:In the obese group, we noted at least 2 mm of prosthetic joint space depression in all of the 8 failured knees, and 4 mm or more than 4 mm in 6 cases. We hypothesize that the reason fot the subsidence of tibial component is the increased loading because of prosthetic joint space depression. The result of this study suggests that tibial component positioning which provides an optimal level of prosthetic joint space reduces the risk of failure in medial UKA, prevents degenerative changes in lateral tibiofemoral joint, and provides better long-term clinical outcome.

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“…The lines are normally noted within 1 year of implantation, but can develop up to 2 years after implantation [1]. There is sometimes a misconception among surgeons that the presence of radiolucency around an implant is always indicative of loosening [2][3][4]. However, Goodfellow and coworkers noted that the presence of radiolucency does not always indicate that implant loosening will occur; the authors described two types of radiolucency: pathological or physiological [1].…”

Section: Introductionmentioning

confidence: 99%

“…Physiological radiolucent lines are generally well defined with a sclerotic margin, non-progressive, less than 2 mm thick, and are not indicative of loosening [1,5]. It is, therefore, important to correctly distinguish between pathological and physiological radiolucent lines to ensure that unnecessary revision of well-fixed components does not occur [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

A semi-automated measurement technique for the assessment of radiolucency

Pegg

Kendrick

Pandit

et al. 2014

J. R. Soc. Interface.

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The assessment of radiolucency around an implant is qualitative, poorly defined and has low agreement between clinicians. Accurate and repeatable assessment of radiolucency is essential to prevent misdiagnosis, minimize cases of unnecessary revision, and to correctly monitor and treat patients at risk of loosening and implant failure. The purpose of this study was to examine whether a semi-automated imaging algorithm could improve repeatability and enable quantitative assessment of radiolucency. Six surgeons assessed 38 radiographs of knees after unicompartmental knee arthroplasty for radiolucency, and results were compared with assessments made by the semi-automated program. Large variation was found between the surgeon results, with total agreement in only 9.4% of zones and a kappa value of 0.602; whereas the automated program had total agreement in 81.6% of zones and a kappa value of 0.802. The software had a 'fair to excellent' prediction of the presence or the absence of radiolucency, where the area under the curve of the receiver operating characteristic curves was 0.82 on average. The software predicted radiolucency equally well for cemented and cementless implants (p ¼ 0.996). The identification of radiolucency using an automated method is feasible and these results indicate that it could aid the definition and quantification of radiolucency.

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The Oxford unicompartmental knee arthroplasty: a radiological perspective

Cited by 35 publications

References 8 publications

Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL

Unicompartmental knee arthroplasty in patients with full versus partial thickness cartilage loss (PTCL): equal in clinical outcome but with higher reoperation rate for patients with PTCL

Medial Unicompartmental Knee Arthroplasty: Correlation Between Components’ Malalignment and Long-term Outcome in Obese Patients

A semi-automated measurement technique for the assessment of radiolucency

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