Minimally invasive Oxford phase 3 unicompartmental knee replacement

H. Pandit, C. Jenkins, H. S. Gill, K. Barker, C. A. Dodd, D. W. Murray

Research output: Contribution to journalArticle

191 Citations (Scopus)

Abstract

This prospective study describes the outcome of the first 1000 phase 3 Oxford medial unicompartmental knee replacements (UKRs) implanted using a minimally invasive surgical approach for the recommended indications by two surgeons and followed up independently. The mean follow-up was 5.6 years (1 to 11) with 547 knees having a minimum follow-up of five years. At five years their mean Oxford knee score was 41.3 (sd 7.2), the mean American Knee Society Objective Score 86.4 (sd 13.4), mean American Knee Society Functional Score 86.1 (sd 16.6), mean Tegner activity score 2.8 (sd 1.1). For the entire cohort, the mean maximum flexion was 130 degrees at the time of final review. The incidence of implant-related re-operations was 2.9%; of these 29 re-operations two were revisions requiring revision knee replacement components with stems and wedges, 17 were conversions to a primary total knee replacement, six were open reductions for dislocation of the bearing, three were secondary lateral UKRs and one was revision of a tibial component. The most common reason for further surgical intervention was progression of arthritis in the lateral compartment (0.9%), followed by dislocation of the bearing (0.6%) and revision for unexplained pain (0.6%). If all implant-related re-operations are considered failures, the ten-year survival rate was 96% (95% confidence interval, 92.5 to 99.5). If only revisions requiring revision components are considered failures the ten-year survival rate is 99.8% (confidence interval 99 to 100). This is the largest published series of UKRs implanted through a minimally invasive surgical approach and with ten-year survival data. The survival rates are similar to those obtained with a standard open approach whereas the function is better. This demonstrates the effectiveness and safety of a minimally invasive surgical approach for implanting the Oxford UKR.
Original languageEnglish
Pages (from-to)198-204
Number of pages7
JournalJournal of Bone and Joint Surgery - British Volume
Volume93
Issue number2
DOIs
Publication statusPublished - 2011

Fingerprint

Knee Replacement Arthroplasties
Knee
Confidence Intervals
Arthritis
Prospective Studies
Safety
Pain
Incidence

Cite this

Minimally invasive Oxford phase 3 unicompartmental knee replacement. / Pandit, H.; Jenkins, C.; Gill, H. S.; Barker, K.; Dodd, C. A.; Murray, D. W.

In: Journal of Bone and Joint Surgery - British Volume, Vol. 93, No. 2, 2011, p. 198-204.

Research output: Contribution to journalArticle

Pandit, H. ; Jenkins, C. ; Gill, H. S. ; Barker, K. ; Dodd, C. A. ; Murray, D. W. / Minimally invasive Oxford phase 3 unicompartmental knee replacement. In: Journal of Bone and Joint Surgery - British Volume. 2011 ; Vol. 93, No. 2. pp. 198-204.
@article{73b5c3c373f4450f9248c8e6c020c6d1,
title = "Minimally invasive Oxford phase 3 unicompartmental knee replacement",
abstract = "This prospective study describes the outcome of the first 1000 phase 3 Oxford medial unicompartmental knee replacements (UKRs) implanted using a minimally invasive surgical approach for the recommended indications by two surgeons and followed up independently. The mean follow-up was 5.6 years (1 to 11) with 547 knees having a minimum follow-up of five years. At five years their mean Oxford knee score was 41.3 (sd 7.2), the mean American Knee Society Objective Score 86.4 (sd 13.4), mean American Knee Society Functional Score 86.1 (sd 16.6), mean Tegner activity score 2.8 (sd 1.1). For the entire cohort, the mean maximum flexion was 130 degrees at the time of final review. The incidence of implant-related re-operations was 2.9{\%}; of these 29 re-operations two were revisions requiring revision knee replacement components with stems and wedges, 17 were conversions to a primary total knee replacement, six were open reductions for dislocation of the bearing, three were secondary lateral UKRs and one was revision of a tibial component. The most common reason for further surgical intervention was progression of arthritis in the lateral compartment (0.9{\%}), followed by dislocation of the bearing (0.6{\%}) and revision for unexplained pain (0.6{\%}). If all implant-related re-operations are considered failures, the ten-year survival rate was 96{\%} (95{\%} confidence interval, 92.5 to 99.5). If only revisions requiring revision components are considered failures the ten-year survival rate is 99.8{\%} (confidence interval 99 to 100). This is the largest published series of UKRs implanted through a minimally invasive surgical approach and with ten-year survival data. The survival rates are similar to those obtained with a standard open approach whereas the function is better. This demonstrates the effectiveness and safety of a minimally invasive surgical approach for implanting the Oxford UKR.",
author = "H. Pandit and C. Jenkins and Gill, {H. S.} and K. Barker and Dodd, {C. A.} and Murray, {D. W.}",
year = "2011",
doi = "10.1302/0301-620X.93B2.25767",
language = "English",
volume = "93",
pages = "198--204",
journal = "Journal of Bone and Joint Surgery - British Volume",
issn = "0301-620X",
publisher = "British Editorial Society of Bone and Joint Surgery",
number = "2",

}

TY - JOUR

T1 - Minimally invasive Oxford phase 3 unicompartmental knee replacement

AU - Pandit, H.

AU - Jenkins, C.

AU - Gill, H. S.

AU - Barker, K.

AU - Dodd, C. A.

AU - Murray, D. W.

PY - 2011

Y1 - 2011

N2 - This prospective study describes the outcome of the first 1000 phase 3 Oxford medial unicompartmental knee replacements (UKRs) implanted using a minimally invasive surgical approach for the recommended indications by two surgeons and followed up independently. The mean follow-up was 5.6 years (1 to 11) with 547 knees having a minimum follow-up of five years. At five years their mean Oxford knee score was 41.3 (sd 7.2), the mean American Knee Society Objective Score 86.4 (sd 13.4), mean American Knee Society Functional Score 86.1 (sd 16.6), mean Tegner activity score 2.8 (sd 1.1). For the entire cohort, the mean maximum flexion was 130 degrees at the time of final review. The incidence of implant-related re-operations was 2.9%; of these 29 re-operations two were revisions requiring revision knee replacement components with stems and wedges, 17 were conversions to a primary total knee replacement, six were open reductions for dislocation of the bearing, three were secondary lateral UKRs and one was revision of a tibial component. The most common reason for further surgical intervention was progression of arthritis in the lateral compartment (0.9%), followed by dislocation of the bearing (0.6%) and revision for unexplained pain (0.6%). If all implant-related re-operations are considered failures, the ten-year survival rate was 96% (95% confidence interval, 92.5 to 99.5). If only revisions requiring revision components are considered failures the ten-year survival rate is 99.8% (confidence interval 99 to 100). This is the largest published series of UKRs implanted through a minimally invasive surgical approach and with ten-year survival data. The survival rates are similar to those obtained with a standard open approach whereas the function is better. This demonstrates the effectiveness and safety of a minimally invasive surgical approach for implanting the Oxford UKR.

AB - This prospective study describes the outcome of the first 1000 phase 3 Oxford medial unicompartmental knee replacements (UKRs) implanted using a minimally invasive surgical approach for the recommended indications by two surgeons and followed up independently. The mean follow-up was 5.6 years (1 to 11) with 547 knees having a minimum follow-up of five years. At five years their mean Oxford knee score was 41.3 (sd 7.2), the mean American Knee Society Objective Score 86.4 (sd 13.4), mean American Knee Society Functional Score 86.1 (sd 16.6), mean Tegner activity score 2.8 (sd 1.1). For the entire cohort, the mean maximum flexion was 130 degrees at the time of final review. The incidence of implant-related re-operations was 2.9%; of these 29 re-operations two were revisions requiring revision knee replacement components with stems and wedges, 17 were conversions to a primary total knee replacement, six were open reductions for dislocation of the bearing, three were secondary lateral UKRs and one was revision of a tibial component. The most common reason for further surgical intervention was progression of arthritis in the lateral compartment (0.9%), followed by dislocation of the bearing (0.6%) and revision for unexplained pain (0.6%). If all implant-related re-operations are considered failures, the ten-year survival rate was 96% (95% confidence interval, 92.5 to 99.5). If only revisions requiring revision components are considered failures the ten-year survival rate is 99.8% (confidence interval 99 to 100). This is the largest published series of UKRs implanted through a minimally invasive surgical approach and with ten-year survival data. The survival rates are similar to those obtained with a standard open approach whereas the function is better. This demonstrates the effectiveness and safety of a minimally invasive surgical approach for implanting the Oxford UKR.

UR - http://www.scopus.com/inward/record.url?scp=79551588002&partnerID=8YFLogxK

UR - http://www.ncbi.nlm.nih.gov/pubmed/21282759

UR - http://dx.doi.org/10.1302/0301-620X.93B2.25767

U2 - 10.1302/0301-620X.93B2.25767

DO - 10.1302/0301-620X.93B2.25767

M3 - Article

VL - 93

SP - 198

EP - 204

JO - Journal of Bone and Joint Surgery - British Volume

JF - Journal of Bone and Joint Surgery - British Volume

SN - 0301-620X

IS - 2

ER -