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ACL damage is associated with progression of arthritis and whilst in the population undergoing joint replacement in the majority of cases the ACL is intact there is a wide spectrum of ACL disease. This study investigated whether the macroscopic status of the ACL affected functional outcome or survival following UKR.The macroscopic status of the ACL was recorded in 820 cemented Oxford UKRs implanted...
The rate of bearing dislocation with the domed lateral Oxford Unicompartmental Knee Replacement (OUKR) in different series varies from 1% to 6% suggesting that dislocation is influenced by surgical technique. The aim of this study was to identify surgical factors associated with dislocation.Aligned post-operative antero-posterior knee radiographs of seven knees that had dislocated and 87 control knees...
Obesity is considered to be a contraindication for unicompartmental knee replacement (UKR). The aim was to study the impact of BMI on failure rate and clinical outcome of the Oxford mobile bearing UKR.Two thousand four hundred and thirty-eight medial Oxford UKRs were studied prospectively and divided into groups: BMI<25 (n=378), BMI 25 to <30 (n=856), BMI 30 to <35 (n=712), BMI 35 to <40...
Intra-operative local anaesthetic infiltration provides good early pain relief after Unicompartmental Knee Replacement (UKR). However, appreciable pain may occur on the day after surgery. The purpose of this double-blinded, prospective randomised controlled trial was to evaluate the effectiveness of a bolus of local intra-articular anaesthetic given early on the day after surgery. Forty-four patients...
It is recommended that in medial compartment osteoarthritis (OA) unicompartmental knee replacement (UKR) should not be undertaken unless there is bone on bone. This recommendation is not evidence based and it is important to know if it is correct as there are many patients with pain and partial thickness cartilage loss (PTCL) who could potentially benefit from UKR. The aim of this study was to determine...
Despite the theoretical advantages of mobile bearings for lateral unicompartmental replacement (UKR), the failure rate in the initial published series of lateral Oxford UKR's was unacceptably high. The main cause of failure was bearing dislocation. To address this problem we first modified the surgical technique and then introduced a new design with a convex domed tibial plateau. This paper presents...
Revision is the gold standard outcome measurement for survival analyses of orthopaedic implants but reliance on revision as an endpoint has been recently questioned. This study, that assesses long-term outcome in a specific group of patients who had undergone total knee replacement (TKR) for osteoarthritis, highlights the main problems facing modern survival analyses. Minimum 12-year survival and...
As implants are made in incremental sizes and usually do not fit perfectly, surgeons have to decide if it is preferable to over or undersize the components. This is particularly important for unicompartmental knee replacement (UKR) tibial components, as overhang may cause irritation of soft tissues and pain, whereas underhang may cause loosening.One hundred and sixty Oxford UKRs were categorised according...
This study's aim was to assess the effect of component mal-alignment on outcome of Oxford Unicompartmental Knee Replacement (UKR). Two hundred and eleven knees implanted with a medial UKR, using a minimally invasive approach, were followed up at a minimum of 4 years. Sagittal and frontal plane femoral and tibial component alignments were determined from antero-posterior and lateral radiographs. The...
Unicompartmental knee arthroplasty (UKA) is increasingly being performed in both specialist centres as well as district hospitals. The radiologists should be aware of the required preoperative imaging, the normal appearance, and complications of this procedure. Unfortunately, very little is available in the radiology literature. This review aims to provide a radiological perspective to an already...
The in vivo kinematics of 10 patients after combined anterior cruciate ligament reconstruction (ACLR group) and Oxford unicompartmental knee arthroplasty (UKA) was compared to those of 10 Oxford UKA patients with an intact ACL (ACLI group) and a group of 22 normal knees. The kinematics during a step-up exercise and a deep knee bend exercise was measured using a fluoroscopic technique. The patellar...
As part of the step-wise validation of a new prosthesis (TMK), we previously published the 1 year results of a randomised controlled trial in patients undergoing bilateral knee replacement [Price A., Rees J., Beard D., Juszczak E. et al. A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. JBJS B 2003;85-B-1:62-7.]. Forty patients had the new mobile-bearing prosthesis implanted...
To describe an accelerated protocol for early discharge of patients undergoing Oxford medial unicompartmental knee arthroplasty using a minimally invasive approach.Prospective observational study.Specialist orthopaedic National Health Service hospital.One hundred consecutive patients (40 female, 60 male) undergoing Oxford medial unicompartmental knee arthroplasty with an average age of 64 (range 44–80)...
Unicompartmental knee arthroplasty (UKA) is appropriate for one in four patients with osteoarthritic knees. This study was performed to compare the safety, effectiveness and economic viability of a new accelerated protocol with current standard care in a state healthcare system. A single blind RCT design was used. Eligible patients were screened for NSAID tolerance, social circumstances and geographical...
Sagittal plane video fluoroscopy was used to analyse the bilateral knee kinematics of patients with unilateral ACL deficiency (ACLD) before, and 4 months after, hamstrings graft ACL reconstruction. Kinematics were studied during weight resisted knee extension, passive knee extension, and a step up. Thigh EMG records were also obtained from five subjects. In addition, six uninjured control subjects...
Oxford medial unicompartmental arthroplasty (UCA) is now routinely performed through a short incision without dislocation of the patella. We present the 1 year results of the first 104 knees operated in Oxford using this technique and the learning curve associated with it. The patient's average age at surgery was 68 years. The average American Knee Society 'knee score' improved from 37 to 94 points...
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