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Oxford domed lateral unicompartmental knee replacement: 10 year survival and 7 year clinical outcome

Abstract:
Aims To report mid- to long-term results of Oxford mobile bearing domed lateral unicompartmental knee arthroplasty (UKA), and determine the effect of potential contraindications on outcome. Methods A total of 325 consecutive domed lateral UKAs undertaken for the recommended indications were included, and their functional and survival outcomes were assessed. The effects of age, weight, activity, and the presence of full-thickness erosions of cartilage in the patellofemoral joint on outcome were evaluated. Results Median follow-up was seven years (3 to 14), and mean age at surgery was 65 years (39 to 90). Median Oxford Knee Score (OKS) was 43 (interquartile range (IQR) 37 to 47), with 260 (80%) achieving a good or excellent score (OKS > 34). Revisions occurred in 34 (10%); 14 (4%) were for dislocation, of which 12 had no recurrence following insertion of a new bearing, and 12 (4%) were revised for medial osteoarthritis (OA). Ten-year survival was 85% (95% confidence interval (CI) 79 to 90, at risk 72). Age, weight, activity, and patellofemoral erosions did not have a significant effect on the clinical outcome or survival. Conclusion Domed lateral UKA provides a good alternative to total knee arthroplasty (TKA) in the management of lateral compartment OA. Although dislocation is relatively easy to treat successfully, the dislocation rate of 4% is high. It is recommended that the stability of the bearing is assessed intraoperatively. If the bearing can easily be displaced, the fixed rather than the mobile bearing version of the Oxford lateral tibial component should be inserted instead. Younger age, heavier weight, high activity, and patellofemoral erosions did not detrimentally affect outcome, so should not be considered contraindications.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1302/0301-620X.102B8.BJJ-2019-1330.R2

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Oxford college:
Green Templeton College
Role:
Author
ORCID:
0000-0002-2330-9743


Publisher:
British Editorial Society of Bone and Joint Surgery
Journal:
Bone and Joint Journal More from this journal
Volume:
102
Issue:
B(8)
Pages:
1033-1040
Publication date:
2020-07-31
Acceptance date:
2020-03-27
DOI:
EISSN:
2049-4408
ISSN:
2049-4394


Language:
English
Keywords:
Pubs id:
1097147
Local pid:
pubs:1097147
Deposit date:
2020-03-28
ARK identifier:

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