Fixed lateral unicompartmental knee replacement is a reliable treatment for lateral compartment osteoarthritis after mobile-bearing medial unicompartmental replacement.

Purpose: Lateral osteoarthritis following medial unicompartmental knee replacement (UKR) is usually treated with total knee replacement, however, lateral UKR is a less invasive option that preserves a well-functioning medial UKR. This study aimed to determine the 5-year outcome of the cemented Fixed Lateral Oxford UKR (FLO) when used for the treatment of severe lateral disease after medial Oxford unicompartmental knee replacement.

Methods: Forty-four knees with lateral bone-on-bone osteoarthritis (n = 43) and avascular necrosis (n = 1) treated with the FLO following medial Oxford UKR were followed up prospectively.

Oxford domed lateral unicompartmental knee arthroplasty.

Aims: To report mid- to long-term results of Oxford mobile bearing domed lateral unicompartmental knee arthroplasty (UKA), and determine the effect of potential contraindications on outcome.

Methods: A total of 325 consecutive domed lateral UKAs undertaken for the recommended indications were included, and their functional and survival outcomes were assessed. The effects of age, weight, activity, and the presence of full-thickness erosions of cartilage in the patellofemoral joint on outcome were evaluated.

The impact of patient-specific instrumentation on unicompartmental knee arthroplasty: a prospective randomised controlled study.

Purpose: Patient-specific instrumentation (PSI) has been proposed as a means of improving surgical accuracy and ease of implantation during technically challenging procedures such as unicompartmental knee arthroplasty (UKA). The purpose of this prospective randomised controlled trial was to compare the accuracy of implantation and functional outcome of mobile-bearing medial UKAs implanted with and without PSI by experienced UKA surgeons.

Methods: Mobile-bearing medial UKAs were implanted in 43 patients using either PSI guides or conventional instrumentation.

The Interaction of Caseload and Usage in Determining Outcomes of Unicompartmental Knee Arthroplasty: A Meta-Analysis.

Background: Outcomes after unicompartmental knee arthroplasty (UKA) are variable and influenced by caseload (UKA/y) and usage (percentage of knee arthroplasty that are UKA), which relates to indications. This meta-analysis assesses the relative importance of these factors.

Methods: MEDLINE (Ovid), Embase (Ovid), and Web of Science (ISI) were searched for consecutive series of cemented Phase 3 Oxford medial UKA.

Evidence-Based Indications for Mobile-Bearing Unicompartmental Knee Arthroplasty in a Consecutive Cohort of Thousand Knees.

Background: The indications for unicompartmental knee arthroplasty remain controversial. Previously recommended contraindications include the following: age under 60 years, weight 180 lb (82 kg) or over, patients undertaking heavy labor, chondrocalcinosis, and exposed bone in the patellofemoral joint. This study explores whether these contraindications are valid in mobile-bearing unicompartmental knee arthroplasty.

Lateral osteophytes do not represent a contraindication to medial unicompartmental knee arthroplasty: a 15-year follow-up.

Purpose: Lateral osteophytes have been reported to be associated with lateral compartment disease and as such it is unclear whether medial unicompartmental knee arthroplasty should be performed if these are present.

Methods: Using the OARSI classification system, 0 (no osteophyte) to 3 (large osteophyte), radiographs from a series of cemented meniscal-bearing unicompartmental knee arthroplasty implanted in the setting of full-thickness lateral cartilage where lateral osteophytes were not considered a contraindication were identified and factors associated with the presence and size of lateral osteophytes, and their impact on clinical outcomes and implant survival were assessed.

Results: Pre-operative radiographs from 458 knees (392 patients), independently followed up for a mean 10.

Does activity affect the outcome of the Oxford unicompartmental knee replacement?

Background: High levels of activity are considered to be a contraindication to unicompartmental knee replacement (UKR) and are not recommended after UKR. To determine if these recommendations should apply to the mobile-bearing Oxford UKR, this study assessed the effect of post-operative activity level on the outcome of this device.

Methods: The outcome of the first 1000 Phase 3 cemented Oxford UKRs implanted between 1998 and 2010 was assessed using survival analysis, the Oxford Knee Score (OKS) and the American Knee Society Objective (KSS-O) and Functional (KSS-F) Scores.

Cementless unicondylar knee arthroplasty.

Cementless fixation is an increasingly popular option in unicondylar knee arthroplasty (UKA). Early cementless UKAs suffered from unreliable fixation and uptake of cementless UKA was limited. However, modern designs of cementless UKA have demonstrated excellent results with improved radiographic appearances when compared with cemented implants.

Does a mixed training course on the Oxford unicompartmental knee arthroplasty improve non-technical skills of orthopaedic surgeons?

Purpose: To determine whether a mixed course on the Oxford unicompartmental knee arthroplasty (UKA) could improve the non-technical (cognitive) skills of performing UKA.

Methods: 120 delegates consisting of consultant orthopaedic surgeons and advanced surgical trainees attended a 2-day course. 104 (87%) of the delegates had performed total knee arthroplasties, whereas 79 (66%) had performed UKAs.

No difference in survivorship after unicompartmental knee arthroplasty with or without an intact anterior cruciate ligament.

Purpose: Anterior cruciate ligament deficiency (ACLD) has been considered a contraindication for Oxford unicompartmental knee arthroplasty (UKA) because of the reported higher incidence of failure when implanted in ACLD knees. However, given the potential advantages of UKA over total knee arthroplasty (TKA), we have performed UKA in a limited number of patients with ACL deficiency and end-stage medial compartment osteoarthritis (OA) over the past 11 years. The primary aim of this study was to establish the clinical outcome of this cohort; the secondary aim was to compare both clinical and radiographic data with a matched cohort of ACL-intact (ACLI) patients who have undergone UKA for anteromedial OA.

Determination of femoral component size in unicompartmental knee replacement.

It is difficult to determine the ideal size of femoral component when a unicompartmental knee replacement (UKR) is implanted with a minimally invasive approach. The aim of the study was to identify the best method of determining femoral component size pre-operatively. This was done by assessing the accuracy with which it could be predicted by pre-operative templating, patient height, gender and tibial component size.

After partial knee replacement, patients can kneel, but they need to be taught to do so: a single-blind randomized controlled trial.

Background And Purpose: Kneeling is an important functional activity frequently not performed after knee replacement, thus affecting a patient's ability to carry out basic daily tasks. Despite no clinical reason preventing kneeling, many patients fail to resume this activity. The purpose of this study was to determine whether a single physical therapy intervention would improve patient-reported kneeling ability following partial knee replacement (PKR).

Medial tibial plateau fracture and the Oxford unicompartmental knee.

Tibial plateau fracture is a rare complication of unicompartmental knee arthroplasty. The fracture almost always occurs during surgery, and it is likely to be the result of a technical error, usually an unnecessarily deep vertical saw cut into the proximal tibia. However, anything that weakens or overloads the proximal tibia may contribute to fracture, such as damage to the posterior cortex, excess removal of bone particularly in small patients with osteopenic bones, inadequate preparation of the keel slot, or use of excessive force with a heavy hammer.

Oxford medial unicompartmental arthroplasty for focal spontaneous osteonecrosis of the knee.

Background: Spontaneous osteonecrosis of the knee (SONK) is a distinct clinical condition occurring in patients without any associated risk factors. There is controversy as to the best method of treatment, and the available literature would suggest that patients with SONK have a worse outcome than those with primary osteoarthrosis when arthroplasty is performed. We assessed the outcome of medial unicompartmental knee arthroplasty (UKA) using the Oxford prosthesis for end-stage focal spontaneous osteonecrosis of the knee (SONK; Ahlbäck grades III and IV).

Sagittal plane kinematics of a mobile-bearing unicompartmental knee arthroplasty at 10 years: a comparative in vivo fluoroscopic analysis.

This study compares in vivo sagittal plane kinematics of the Oxford mobile-bearing unicompartmental knee arthroplasty (UKA) at 1 and 10 years' postsurgery (10 knees) with a fixed-bearing total knee arthroplasty (TKA) (5 knees) and the normal knee (5 knees), using dynamic fluoroscopic measurement of the patellar tendon angle. The Oxford UKA preserved normal changes in patellar tendon angle with flexion, and this was maintained at 10 years. In contrast, an abnormal pattern was seen with the TKA.