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Causes of revision following Oxford phase 3 unicompartmental knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Revision of unicompartmental knee arthroplasty (UKA) is relatively rare, but there is concern that the minimally invasive approach might result in more complications and a higher rate of revision. Current data regarding the revision of UKA using the Oxford phase 3 prosthesis are confined to a few reviews of single-institution experience. The purpose of this study was to provide an evidence-based summarisation of the revision of UKA with a pooled analysis of the reported cases.

Methods

A systematic review of published studies that evaluated the causes that required further surgical intervention after UKA using the Oxford phase 3 prosthesis was performed. A structured literature review of multiple databases referenced articles from 1998 to 2012. The revision rates between Asian population and western population were compared.

Results

A total of 2,683 patients (3,138 knees) from 17 published studies were assessed. The median age of the patients was 62.5 (range 32–93) years. The median follow-up period was 5.6 (range 0.1–11) years. Postoperative revision was necessary in 146 knees with a pooled percentage of 4.6 %. Bearing dislocation was found to be the single most important predisposing cause of revision, with a pooled percentage of 1.5 % (47/3,138 knees). The rate of bearing dislocation was significantly higher in Asian population than that in western population (p < 0.001).

Conclusions

Mobile bearing UKA seems to be less appropriate for the Asian population as extreme knee flexion is required for cultural purposes.

Level of evidence

Retrospective case series, Level IV.

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References

  1. Assor M, Aubaniac JM (2006) Influence of rotatory malposition of femoral implant in failure of unicompartmental medial knee prosthesis. Rev Chir Orthop Reparatrice Appar Mot 92(5):473–484

    Article  CAS  PubMed  Google Scholar 

  2. Baker PN, Petheram T, Avery PJ, Gregg PJ, Deehan DJ (2012) Revision for unexplained pain following unicompartmental and total knee replacement. J Bone Jt Surg Am 94(17):e126

    Article  Google Scholar 

  3. Barrett WP, Scott RD (1987) Revision of failed unicondylar unicompartmental knee arthroplasty. J Bone Jt Surg Am 69(9):1328–1335

    CAS  Google Scholar 

  4. Berend KR, Lombardi AV Jr, Adams JB (2007) Obesity, young age, patellofemoral disease, and anterior knee pain: identifying the unicondylar arthroplasty patient in the United States. Orthopedics 30(5 Suppl):19–23

    PubMed  Google Scholar 

  5. Choy WS, Kim KJ, Lee SK, Yang DS, Kim CM, Park JS (2011) Medial unicompartmental knee arthroplasty in patients with spontaneous osteonecrosis of the knee. Clin Orthop Surg 3(4):279–284

    Article  PubMed Central  PubMed  Google Scholar 

  6. Choy WS, Kim KJ, Lee SK, Yang DS, Lee NK (2011) Mid-term results of oxford medial unicompartmental knee arthroplasty. Clin Orthop Surg 3(3):178–183

    Article  PubMed Central  PubMed  Google Scholar 

  7. Clement ND, Duckworth AD, MacKenzie SP, Nie YX, Tiemessen CH (2012) Medium-term results of Oxford phase-3 medial unicompartmental knee arthroplasty. J Orthop Surg 20(2):157–161

    Google Scholar 

  8. Cool S, Victor J, De Baets T (2006) Does a minimally invasive approach affect positioning of components in unicompartmental knee arthroplasty? Early results with survivorship analysis. Acta Orthop Belg 72(6):709–715

    PubMed  Google Scholar 

  9. Emerson RH Jr (2005) Unicompartmental mobile-bearing knee arthroplasty. Instr Course Lect 54:221–224

    PubMed  Google Scholar 

  10. Emerson RH Jr, Hansborough T, Reitman RD, Rosenfeldt W, Higgins LL (2002) Comparison of a mobile with a fixed-bearing unicompartmental knee implant. Clin Orthop Relat Res 404:62–70

    Article  PubMed  Google Scholar 

  11. Gleeson RE, Evans R, Ackroyd CE, Webb J, Newman JH (2004) Fixed or mobile bearing unicompartmental knee replacement? A comparative cohort study. Knee 11(5):379–384

    Article  CAS  PubMed  Google Scholar 

  12. Goodfellow JW, Kershaw CJ, Benson MK, O’Connor JJ (1988) The Oxford Knee for unicompartmental osteoarthritis. The first 103 cases. J Bone Jt Surg Br 70(5):692–701

    CAS  Google Scholar 

  13. Goodfellow JW, O’Connor JJ, Murray DW (2010) A critique of revision rate as an outcome measure: re-interpretation of knee joint registry data. J Bone Jt Surg Br 92(12):1628–1631

    Article  CAS  Google Scholar 

  14. Heller S, Fenichel I, Salai M, Luria T, Velkes S (2009) The Oxford unicompartmental knee prosthesis for the treatment of medial compartment knee disease: 2 to 5 year follow-up. Isr Med Assoc J 11(5):266–268

    PubMed  Google Scholar 

  15. Jung KA, Lee SC, Hwang SH (2009) Pseudomeniscal synovial impingement after unicondylar knee arthroplasty. Orthopedics 32(5):361

    Article  PubMed  Google Scholar 

  16. Keys GW (1999) Reduced invasive approach for Oxford II medial unicompartmental knee replacement—a preliminary study. Knee 6(3):193–196

    Article  Google Scholar 

  17. Kim KT, Lee S, Park HS, Cho KH, Kim KS (2007) A prospective analysis of Oxford phase 3 unicompartmental knee arthroplasty. Orthopedics 30(5 Suppl):15–18

    PubMed  Google Scholar 

  18. Kort NP, van Raay JJ, Cheung J, Jolink C, Deutman R (2007) Analysis of Oxford medial unicompartmental knee replacement using the minimally invasive technique in patients aged 60 and above: an independent prospective series. Knee Surg Sports Traumatol Arthrosc 15(11):1331–1334

    Article  PubMed Central  PubMed  Google Scholar 

  19. Koshino T, Morii T, Wada J, Takahashi S (1991) Unicompartmental replacement with the Marmor Modular knee: operative procedure and results. Bull Hosp Jt Dis Orthop Inst 51(2):119–131

    CAS  PubMed  Google Scholar 

  20. Koshino T, Saito T, Orito K, Mitsuhashi S, Takeuchi R, Kurosaka T (2002) Increase in range of knee motion to obtain floor sitting after high tibial osteotomy for osteoarthritis. Knee 9(3):189–196

    Article  PubMed  Google Scholar 

  21. Koskinen E, Paavolainen P, Eskelinen A, Harilainen A, Sandelin J, Ylinen P, Tallroth K, Remes V (2009) Medial unicompartmental knee arthroplasty with Miller-Galante II prosthesis: mid-term clinical and radiographic results. Arch Orthop Trauma Surg 129(5):617–624

    Article  PubMed  Google Scholar 

  22. Kuipers BM, Kollen BJ, Bots PC, Burger BJ, van Raay JJ, Tulp NJ, Verheyen CC (2010) Factors associated with reduced early survival in the Oxford phase III medial unicompartment knee replacement. Knee 17(1):48–52

    Article  PubMed  Google Scholar 

  23. Labek G, Sekyra K, Pawelka W, Janda W, Stockl B (2011) Outcome and reproducibility of data concerning the Oxford unicompartmental knee arthroplasty: a structured literature review including arthroplasty registry data. Acta Orthop 82(2):131–135

    Article  PubMed Central  PubMed  Google Scholar 

  24. Laubenthal KN, Smidt GL, Kettelkamp DB (1972) A quantitative analysis of knee motion during activities of daily living. Phys Ther 52(1):34–43

    CAS  PubMed  Google Scholar 

  25. Lewold S, Goodman S, Knutson K, Robertsson O, Lidgren L (1995) Oxford meniscal bearing knee versus the Marmor knee in unicompartmental arthroplasty for arthrosis. A Swedish multicenter survival study. J Arthroplast 10(6):722–731

    Article  CAS  Google Scholar 

  26. Lim HC, Bae JH, Song SH, Kim SJ (2012) Oxford phase 3 unicompartmental knee replacement in Korean patients. J Bone Jt Surg Br 94(8):1071–1076

    Article  Google Scholar 

  27. Lisowski LA, van den Bekerom MP, Pilot P, van Dijk CN, Lisowski AE (2011) Oxford Phase 3 unicompartmental knee arthroplasty: medium-term results of a minimally invasive surgical procedure. Knee Surg Sports Traumatol Arthrosc 19(2):277–284

    Article  PubMed Central  PubMed  Google Scholar 

  28. Lisowski LA, Verheijen PM, Lisowski AE (2004) Oxford phase 3 unicompartmental knee arthroplasty (UKA): clinical and radiological results of minimum follow-up of 2 years. Ortop Traumatol Rehabil 6(6):773–776

    PubMed  Google Scholar 

  29. Lombardi AV, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA (2009) Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res 467:1450–1457

    Article  PubMed Central  PubMed  Google Scholar 

  30. Luscombe KL, Lim J, Jones PW, White SH (2007) Minimally invasive Oxford medial unicompartmental knee arthroplasty. A note of caution! Int Orthop 31(3):321–324

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. Mullaji AB, Sharma A, Marawar S (2007) Unicompartmental knee arthroplasty: functional recovery and radiographic results with a minimally invasive technique. J Arthroplast 22(4 Suppl 1):7–11

    Article  Google Scholar 

  32. Mullaji AB, Shetty GM, Kanna R (2011) Postoperative limb alignment and its determinants after minimally invasive Oxford medial unicompartmental knee arthroplasty. J Arthroplast 26(6):919–925

    Article  Google Scholar 

  33. Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB (2005) Does total knee replacement restore normal knee function? Clin Orthop Relat Res 431:157–165

    Article  PubMed  Google Scholar 

  34. Pandit H, Jenkins C, Barker K, Dodd CA, Murray DW (2006) The Oxford medial unicompartmental knee replacement using a minimally-invasive approach. J Bone Jt Surg Br 88(1):54–60

    Article  CAS  Google Scholar 

  35. Pandit H, Jenkins C, Gill HS, Barker K, Dodd CA, Murray DW (2011) Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Jt Surg Br 93(2):198–204

    Article  CAS  Google Scholar 

  36. Price AJ, O’Connor JJ, Murray DW, Dodd CA, Goodfellow JW (2007) A history of Oxford unicompartmental knee arthroplasty. Orthopedics 30(5 Suppl):7–10

    PubMed  Google Scholar 

  37. Price AJ, Webb J, Topf H, Dodd CA, Goodfellow JW, Murray DW, Oxford H, Knee G (2001) Rapid recovery after oxford unicompartmental arthroplasty through a short incision. J Arthroplast 16(8):970–976

    Article  CAS  Google Scholar 

  38. Rees JL, Price AJ, Beard DJ, Dodd CA, Murray DW (2004) Minimally invasive Oxford unicompartmental knee arthroplasty: functional results at 1 year and the effect of surgical inexperience. Knee 11(5):363–367

    Article  CAS  PubMed  Google Scholar 

  39. Riebel GD, Werner FW, Ayers DC, Bromka J, Murray DG (1995) Early failure of the femoral component in unicompartmental knee arthroplasty. J Arthroplast 5:615–621

    Article  Google Scholar 

  40. Robertsson O, Knutson K, Lewold S, Lidgren L (2001) The routine of surgical management reduces failure after unicompartmental knee arthroplasty. J Bone Jt Surg Br 83B(1):45–49

    Article  Google Scholar 

  41. Siddiqui NA, Ahmad ZM (2012) Revision of unicondylar to total knee arthroplasty: a systematic review. Open Orthop J 6:268–275

    Article  PubMed Central  PubMed  Google Scholar 

  42. Song MH, Kim BH, Ahn SJ, Yoo SH, Lee MS (2009) Early complications after minimally invasive mobile-bearing medial unicompartmental knee arthroplasty. J Arthroplast 24(8):1281–1284

    Article  Google Scholar 

  43. Steele RG, Hutabarat S, Evans RL, Ackroyd CE, Newman JH (2006) Survivorship of the St Georg Sled medial unicompartmental knee replacement beyond 10 years. J Bone Jt Surg Br 88B(9):1164–1168

    Article  Google Scholar 

  44. Sun PF, Jia YH (2012) Mobile bearing UKA compared to fixed bearing TKA: a randomized prospective study. Knee 19(2):103–106

    Article  PubMed  Google Scholar 

  45. Vardi G, Strover AE (2004) Early complications of unicompartmental knee replacement: the Droitwich experience. Knee 11(5):389–394

    Article  CAS  PubMed  Google Scholar 

  46. W-Dahl A, Robertsson O, Lidgren L, Miller L, Davidson D, Graves S (2010) Unicompartmental knee arthroplasty in patients aged less than 65. Acta Orthop 81(1):90–94

    Article  PubMed Central  PubMed  Google Scholar 

  47. Weiss JM, Noble PC, Conditt MA, Kohl HW, Roberts S, Cook KF, Gordon MJ, Mathis KB (2002) What functional activities are important to patients with knee replacements? Clin Orthop Relat Res 404:172–188

    Article  PubMed  Google Scholar 

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Correspondence to Jong Hun Kim.

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Kim, SJ., Postigo, R., Koo, S. et al. Causes of revision following Oxford phase 3 unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22, 1895–1901 (2014). https://doi.org/10.1007/s00167-013-2644-3

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  • DOI: https://doi.org/10.1007/s00167-013-2644-3

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