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Minimally invasive Oxford unicompartmental knee arthroplasty ensures excellent functional outcome and high survivorship in the long term

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Whether unicompartimental or total knee arthroplasty is superior for treatment of anteromedial knee osteoarthritis, is still uncertain. Therefore, the purpose of this study was to evaluate clinical and radiological outcome as well as long-term survivorship of medial Oxford unicompartmental knee arthroplasty (OUKA) at an independent center with a minimum follow-up of 10 years.

Methods

This single-center retrospective cohort study reports the 10–15 years follow-up results of 113 consecutive patients (126 knees) after medial OUKA. Survivorship analysis was performed with several different endpoints and clinical outcome was measured using the Oxford Knee Score (OKS), American Knee Society Score (AKSS-O), range of motion (ROM), Tegner activity score and UCLA score. Radiological analysis was performed with focus on progression of arthritis in the lateral compartment.

Results

A total of 16 patients (16 knees) underwent revision surgery resulting in a survival rate of 92.4% at 10 years and 88.6% at 15 years with the endpoint device-related revisions. The main reason for revision surgery was progression of arthritis in five patients (31.3%) followed by persistency of pain in three patients (18.7%). Clinical outcome was good to excellent with an OKS of 39.9 at 11 years, an AKSS-O of 89.3 and a mean range of motion of 122°. The radiological analysis revealed a significant progression of degenerative changes in the lateral compartment, however without any impact on the functional outcome.

Conclusion

Oxford UKA of the medial compartment ensures good long-term survivorship with an excellent functional outcome. Therefore, the results of this study support the continued use of OUKA in patients with anteromedial osteoarthritis.

Level of evidence

Retrospective cohort study, Level III.

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Funding

No external funding was used.

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Authors and Affiliations

  1. Center for Orthopaedics and Trauma Surgery, University of Heidelberg, Schlierbacher Landstrasse 200a, 69118, Heidelberg, Germany

    Tilman Walker, Pit Hetto, Christian Merle, Benjamin Panzram, Moritz M. Innmann & Babak Moradi

  2. Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany

    Thomas Bruckner

  3. Center for Orthopaedics and Trauma surgery, University of Linz, Krankenhausstr. 7a, 4020, Linz, Austria

    Tobias Gotterbarm

Authors
  1. Tilman Walker
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  2. Pit Hetto
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  3. Thomas Bruckner
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  4. Tobias Gotterbarm
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  5. Christian Merle
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  6. Benjamin Panzram
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  7. Moritz M. Innmann
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  8. Babak Moradi
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Corresponding author

Correspondence to Babak Moradi.

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Conflict of interest

Dr. Walker, Mr. Hetto, Dr. Bruckner, Dr. Panzram, Dr. Innmann and Dr. Moradi have nothing to declare. Dr. Gotterbarm reports grants and personal fees from Zimmer Biomet, Europe, grants and personal fees from Depuy Synthes Orthopädie Gmbh, outside the submitted work; Dr. Merle reports grants and personal fees from Zimmer Biomet, personal fees from Thieme, outside the submitted work.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Walker, T., Hetto, P., Bruckner, T. et al. Minimally invasive Oxford unicompartmental knee arthroplasty ensures excellent functional outcome and high survivorship in the long term. Knee Surg Sports Traumatol Arthrosc 27, 1658–1664 (2019). https://doi.org/10.1007/s00167-018-5299-2

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  • DOI: https://doi.org/10.1007/s00167-018-5299-2

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