The twin peg Oxford knee — Medium term survivorship and surgical principles

White, Stephen H.; Roberts, Sharon E.; Kuiper, Jan Herman

doi:10.1016/j.knee.2018.01.001

Cited by 3 publications

(9 citation statements)

References 25 publications

(33 reference statements)

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“…Regarding the loosening of the femoral component, the more likely explanation is the simultaneous introduction of the twin-peg femoral component, which is designed to strengthen fixation and is proven to reduce femoral component loosening. 28 Our study has several limitations of which the differences between the two groups are most important. First, we had to perform a multivariable Cox regression to adjust for important differences as age, ASA score, surgical history of the affected knee, and type of fixation that are known to affect the risk for revision.…”

Section: Discussionmentioning

confidence: 91%

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Reduced 5-Year Risk for Revision of the Oxford UKA Using New Instrumentation versus Conventional Instrumentation: A Registry Study of 12,867 UKAs

et al. 2022

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Background and purpose: Microplasty instrumentation was introduced for a more consistent surgical implantation technique, especially component alignment and tibial resection level, of the Oxford medial unicompartmental knee replacement (UKA) and thereby aims to improve UKA survival. This study aimed to assess the 5-year risk for revision and reasons for revision of the Oxford medial UKA using the new instrumentation (Microplasty) with its predecessor, i.e., conventional instrumentation (Phase 3). Patients and Methods: Data of all medial UKAs from the Dutch Arthroplasty Register (LROI) between 2007-2019 were collected. Type of instrumentation was divided into new (Microplasty) and conventional instrumentation. Kaplan-Meier analysis was performed to calculate 5-year cumulative revision percentage with any reason for revision as endpoint. A multivariable Cox regression with outcome revision of UKA adjusted for age, gender, American Society of Anesthesiologists-score, surgical history, and type of fixation was performed. Additionally, reasons for revision at 3-year were assessed and tested through Fisher’s exact tests. Results: 12,867 Oxford medial UKAs, 8,170 using new and 4,697 using conventional instrumentation, were included. The 5-year revision percentage was 9.2% (CI 8.4-10.1%) for UKAs using the conventional and 6.1% (CI 5.4-6.7%) for new instrumentation. The adjusted hazard ratio for revision at 5-year follow-up was 0.68 (CI 0.59-0.79) in favor of UKAs using the new instrumentation. Malalignment was less frequently registered as reason for revision in UKAs using the conventional compared to the new instrumentation (16.2% versus 7%; p=0.001). Interpretation: Our results show a reduced 5-year risk for revision of the medial Oxford UKAs using the new compared to the conventional instrumentation. This might be the result of a lower revision rate for malalignment in UKAs using the new instrumentation.

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Section: Discussionmentioning

confidence: 91%

“…term results, and furthermore, no association was found with femoral component loosening. Regarding the loosening of the femoral component, the more likely explanation is the simultaneous introduction of the twin-peg femoral component, which is designed to strengthen fixation and is proven to reduce femoral component loosening [28].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Reduced 5-Year Risk for Revision of the Oxford UKA Using New Instrumentation versus Conventional Instrumentation: A Registry Study of 12,867 UKAs

et al. 2022

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“…Instability is a relatively rare complication after UKA with an estimated incidence rate of about 0.12% (10 revisions/8,658 pooled cases), with reports up to 0.7%. 2 , 73 However, one should recognize overlap in aetiopathogenesis with bearing dislocation. 74 …”

Section: Resultsmentioning

confidence: 99%

“…Ten cases of instability leading to revision of a UKA have been described in four papers. 52 , 73 - 75 The timing of revision (described for 6/10 cases) ranged from one to nine years. 52 , 73 , 75 Instability was not further defined.…”

Section: Resultsmentioning

confidence: 99%

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A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

et al. 2021

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Unicompartmental knee arthroplasty (UKA) has several advantages over total knee arthroplasty; however, in many reports, the risk of revision remains higher after UKA. Many reasons for failure of UKA exist. Successful treatment starts with accurate assessment of the symptomatic UKA as a specific mode of failure requires a specific solution. A structured and comprehensive evaluation aids assessment of the symptomatic UKA. This review provides an overview of the causes for a symptomatic medial UKA, its risk factors, diagnostic modalities that can be used, and briefly discusses treatment options. Cite this article: EFORT Open Rev 2021;6:850-860. DOI: 10.1302/2058-5241.6.200105

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Cementless unicompartmental knee replacement achieves better ten-year clinical outcomes than cemented: a systematic review

Mohammad

Bullock

Kennedy

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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The aim of this study was to report and compare the long term revision rate, revision indications and patient reported outcome measures of cemented and cementless Unicompartmental knee replacements (UKR).Methods: Databases Medline, Embase and Cochrane Central of Controlled Trials were searched to identify all UKR studies reporting the ≥10 year clinical outcomes. Revision rates per 100 component years (% per annum (%pa)) were calculated by fixation type and then subgroup analysis for fixed and mobile bearing UKRs was performed. Mechanisms of failure and patient reported outcome measures are reported.Results: 25 studies were eligible for inclusion (n=10,736), of which there were 8790 cemented and 1946 cementless UKRs. The revision rate was 0.73%pa (CI 0.66-0.80) and 0.45%pa (CI 0.34-0.58) per 100 component years respectively with the cementless having a significantly (p<0.001) lower overall revision rate. Therefore, based on these studies, the expected 10 year survival of cementless UKR would be 95.5% and cemented 92.7%. Subgroup analysis revealed this difference remained significant for the Oxford UKR (0.37%pa vs 0.77%pa, p<0.001), but for non-Oxford UKRs, there were no significant differences in revision rates of cemented and cementless UKRs (0.57%pa vs 0.69% pa, p=0.41). Mobile bearing UKRs had significantly lower revision rates than fixed bearing UKRs in cementless (p=0.001), but not cemented groups (p=0.13). Overall the revision rates for aseptic loosening and disease progression were significantly lower (p=0.02 and p=0.009 respectively) in the cementless group compared to the cemented group (0.06 vs 0.13%pa and 0.10 vs 0.21%pa respectively).Conclusions: Cementless fixation had reduced long term revision rates compared to cemented for the Oxford UKR. For the non-Oxford UKRs the revision rates of cementless and cemented fixation types were equivalent. Therefore cementless UKRs offer at least equivalent if not lower revision rates compared to cemented UKRs.

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The twin peg Oxford knee — Medium term survivorship and surgical principles

Abstract: Using our surgical principles the cemented twin peg Oxford knee can result in good medium to long-term implant survival, comparable to those obtained by the originating centre for the single peg Oxford knee.

Cited by 3 publications

References 25 publications

Reduced 5-Year Risk for Revision of the Oxford UKA Using New Instrumentation versus Conventional Instrumentation: A Registry Study of 12,867 UKAs

Reduced 5-Year Risk for Revision of the Oxford UKA Using New Instrumentation versus Conventional Instrumentation: A Registry Study of 12,867 UKAs

A structured evaluation of the symptomatic medial Oxford unicompartmental knee arthroplasty (UKA)

Cementless unicompartmental knee replacement achieves better ten-year clinical outcomes than cemented: a systematic review

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