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A Second Decade Lifetable Survival Analysis of the Oxford Unicompartmental Knee Arthroplasty

  • Symposium: Papers Presented at the Annual Meetings of the Knee Society
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Clinical Orthopaedics and Related Research®

Abstract

Background

The role of unicompartmental arthroplasty in managing osteoarthritis of the knee remains controversial. The Oxford medial unicompartmental arthroplasty employs a fully congruent mobile bearing intended to reduce wear and increase the lifespan of the implant. Long-term second decade results are required to establish if the design aim can be met.

Questions/purposes

We report the (1) 20-year survivorship for the Oxford mobile bearing medial unicompartmental knee arthroplasty; (2) reasons for the revisions; and (3) time to revision.

Methods

We reviewed a series of 543 patients who underwent 682 medial Oxford meniscal bearing unicompartmental knee arthroplasties performed between 1983 and January 2005. The mean age at implantation was 69.7 years (range, 48–94 years). The median followup was 5.9 years (range, 0.5 to 22 years). One hundred and forty-one patients (172 knees) died. None were lost to followup. The primary outcome was 20-year survival, a key variable in assessing the longevity of arthroplasty.

Results

The 16-year all cause revision cumulative survival rate was 91.0% (CI 6.4, 71 at risk) and survival was maintained to 20 years (91.0%, CI 36.2, 14 at risk). There had been 29 revision procedures: 10 for lateral arthrosis, nine for component loosening, five for infection, two bearing dislocations, and three for unexplained pain. In addition, five patients had undergone bearing exchange, four for dislocation and one for bearing fracture. The mean time to revision was 3.3 years (range, 0.3–8.9 years).

Conclusions

Mobile bearing unicompartmental knee arthroplasty is durable during the second decade after implantation.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Dr G. Gudmundsson and Dr B. Tjörnstrand, Consultant Surgeons at the Orthopaedic Department in Skaraborgs Sjukhus Kärnsjukhuset Hospital, for their support of this work.

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Authors and Affiliations

  1. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, Biomedical Research Unit, Nuffield Orthopaedic Centre, Headington, Oxford, OX3 7LD, UK

    Andrew J. Price DPhil FRCS(Orth)

  2. Skaraborgs Sjukhus Kärnsjukhuset, Skövde, Sweden

    Ulf Svard MD

Authors
  1. Andrew J. Price DPhil FRCS(Orth)
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  2. Ulf Svard MD
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Corresponding author

Correspondence to Andrew J. Price DPhil FRCS(Orth).

Additional information

One or more of the authors (AJP) has received research funding from Biomet Inc. This work was funded by the NHS Biomedical Research Unit at the Nuffield Orthopaedic Centre and the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, Oxford University.

This work was performed at Skaraborgs Sjukhus Kärnsjukhuset, Skövde, Sweden, and the Biomedical Research Unit, Nuffield Orthopaedic Centre, Oxford, UK.

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Price, A.J., Svard, U. A Second Decade Lifetable Survival Analysis of the Oxford Unicompartmental Knee Arthroplasty. Clin Orthop Relat Res 469, 174–179 (2011). https://doi.org/10.1007/s11999-010-1506-2

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  • DOI: https://doi.org/10.1007/s11999-010-1506-2

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