Effect of accuracy of phase 3 Oxford prosthesis positioning on short-term effectiveness of unicompartmental knee arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHAO Dongfang ¹ , KONG Xiangpeng ² , WANG Yi ² , NI Ming ² , LI Xiang ² ,  CHAI Wei ²

1. Department of Orthopedics, the People’s Hospital of Puyang, Puyang Henan, 457000, P.R.China;
2. Department of Orthopedics, General Hospital of Chinese PLA, Beijing, 100853, P.R.China;

Corresponding author：

CHAI Wei, Email: Chaiwei301@163.com

Keywords：

Unicompartmental knee arthroplasty; phase 3 Oxford prosthesis; radiographic score; functional score

DOI：

10.7507/1002-1892.201805021

Video：

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Objective To investigate the effect of accuracy of phase 3 Oxford prosthesis positioning on short-term effectiveness of unicompartmental knee arthroplasty (UKA). Methods The clinical data of 26 patients (26 knees) who were treated with UKA between September 2015 and November 2015 was retrospectively analyzed. The single-peg Oxford prosthesis was implanted in 15 patients (single-peg group), and twin-peg Oxford prosthesis was implanted in 11 patients (twin-peg group). There was no significant difference in gender, age, body mass index, Kellgren-Lawrence grading, and preoperative Hospital for Special Surgery (HSS) scores between 2 groups (P>0.05). HSS, knee society score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and Oxford knee score (OKS) were used to evaluate the knee function. Radiographic criteria for Oxford UKA was used to evaluate the prosthesis position. The reason and treatment of bearing dislocations were recorded. Results All patients were followed up with mean follow-up time of 26.2 months in single-peg group (range, 24-27 months) and 25.2 months in twin-peg group (range, 24-26 months). The bearing dislocation occurred in 2 cases of twin-peg group during follow-up. At last follow-up, there was no significant difference in HSS, WOMAC, OKS, and KSS scores between 2 groups (P>0.05). There was no significant difference in radiographic scores of femoral component, tibial component, and overall components between 2 groups (P>0.05). No significant correlation was found between radiographic scores and postoperative functional outcome in 2 groups (P>0.05). Conclusion Within a safe range, the accuracy of phase 3 Oxford prosthesis positioning has limited influence on the short-term functional outcome.

Citation： ZHAO Dongfang, KONG Xiangpeng, WANG Yi, NI Ming, LI Xiang, CHAI Wei. Effect of accuracy of phase 3 Oxford prosthesis positioning on short-term effectiveness of unicompartmental knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(12): 1518-1523. doi: 10.7507/1002-1892.201805021 Copy

1.	卢明峰, 钟露斌, 李泽晖, 等. 牛津单髁置换术与全膝关节置换术治疗膝内侧单间室骨关节炎的近期疗效对比研究. 中华骨与关节外科杂志, 2016, 9(6): 476-479.
2.	文涛, 涂意辉, 薛华明, 等. 单髁置换术与全膝置换术的经济效益分析. 中华关节外科杂志 (电子版), 2017, 11(2): 29-33.
3.	Smith T, Chester R, Glasgow MM, et al. Accelerated rehabilitation following Oxford unicompartmental knee arthroplasty: five-year results from an independent centre. European Journal of Orthopaedic Surgery & Traumatology, 2012, 22(2): 151-158.
4.	Price AJ, Svard U. A second decade lifetable survival analysis of the Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res, 2011, 469(1): 174-179.
5.	Thienpont E. Conversion of a unicompartmental knee arthroplasty to a total knee arthroplasty: can we achieve a primary result. Bone Joint J, 2017, 99-B(1 Supple A): 65-69.
6.	Haughom BD, Schairer WW, Hellman MD, et al. An analysis of risk factors for short-term complication rates and increased length of stay following unicompartmental knee arthroplasty. HSS Journal, 2015, 11(2): 112-116.
7.	Jin KL, Kim HJ, Park JO, et al. Inferior outcome of revision of unicompartmental knee arthroplasty to total knee arthroplasty compared with primary total knee arthroplasty: systematic review and meta-analysis. Knee Surgery Sports Traumatology Arthroscopy, 2018, 26(11): 3403-3418.
8.	Edmondson MC, Isaac D, Wijeratna M, et al. Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term. J Orthop Surg Res, 2011, 6(1): 52.
9.	Chatellard R, Sauleau V, Colmar M, et al. Medial unicompartmental knee arthroplasty: Does tibial component position influence clinical outcomes and arthroplasty survival. Orthopaedics & Traumatology: Surgery & Research, 2013, 99(4): S219-S225.
10.	Assor M, Aubaniac JM. Influence of rotatory malposition of femoral implant in failure of unicompartmental medial knee prosthesis. Rev Chir Orthop Reparatrice Appar Mot, 2006, 92(5): 473-484.
11.	马路遥, 郭万首, 张启栋. 胫骨假体后倾对 Oxford 单髁关节置换术后短期临床结果的影响. 中华外科杂志, 2017, 55(6): 430-434.
12.	孔祥朋, 任鹏, 倪明, 等. 全膝关节置换术中三阶段关节腔周围注射鸡尾酒与股神经阻滞镇痛效果的比较. 中国骨与关节杂志, 2016, 5(10): 752-756.
13.	孔祥朋, 王岩, 柴伟, 等. 人工全髋关节置换术中应用组织胶水与传统缝合法的比较研究. 中国修复重建外科杂志, 2016, 30(12): 1467-1471.
14.	Shakespeare D, Ledger M, Kinzel V. Accuracy of implantation of components in the Oxford knee using the minimally invasive approach. Knee, 2005, 12(6): 405-409.
15.	Gulati A, Chau R, Simpson DJ, et al. Influence of component alignment on outcome for unicompartmental knee replacement. Knee, 2009, 16(3): 196-199.
16.	Kang KT, Son J, Baek C, et al. Femoral component alignment in unicompartmental knee arthroplasty leads to biomechanical change in contact stress and collateral ligament force in knee joint. Arch Orthop Trauma Surg, 2018, 138(4): 563-572.
17.	Hurst JM, Berend KR, Adams JB, et al. Radiographic comparison of mobile-bearing partial knee single-peg versus twin-peg design. J Arthroplasty, 2015, 30(3): 475-478.
18.	White SH, Roberts S, Kuiper JH. The twin peg Oxford knee—medium term survivorship and surgical principles. Knee, 2018, 25(2): 314-322.
19.	贾笛, 李彦林, 王国梁, 等. 利用计算机辅助技术分析膝关节单髁置换术翻修原因. 中国修复重建外科杂志, 2016, 30(1): 119-122.
20.	Kim KT, Lee S, Lee JI, et al. Analysis and treatment of complications after unicompartmental knee arthroplasty. Knee Surg Relat Res, 2016, 28(1): 46-54.
21.	Mohammad HR, Strickland L, Hamilton TW, et al. Long-term outcomes of over 8,000 medial Oxford phase 3 unicompartmental knees—a systematic review. Acta Orthopaedica, 2017, 89(3): 101-107.
22.	Hernigou P, Deschamps G. Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res, 2004, (423): 161-165.
23.	Epinette JA, Brunschweiler B, Mertl P, et al. Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res, 2012, 98(6 Suppl): S124-S130.
24.	Pandit H, Jenkins C, Gill HS, et al. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg (Br), 2011, 93(2): 198-204.

1. 卢明峰, 钟露斌, 李泽晖, 等. 牛津单髁置换术与全膝关节置换术治疗膝内侧单间室骨关节炎的近期疗效对比研究. 中华骨与关节外科杂志, 2016, 9(6): 476-479.
2. 文涛, 涂意辉, 薛华明, 等. 单髁置换术与全膝置换术的经济效益分析. 中华关节外科杂志 (电子版), 2017, 11(2): 29-33.
3. Smith T, Chester R, Glasgow MM, et al. Accelerated rehabilitation following Oxford unicompartmental knee arthroplasty: five-year results from an independent centre. European Journal of Orthopaedic Surgery & Traumatology, 2012, 22(2): 151-158.
4. Price AJ, Svard U. A second decade lifetable survival analysis of the Oxford unicompartmental knee arthroplasty. Clin Orthop Relat Res, 2011, 469(1): 174-179.
5. Thienpont E. Conversion of a unicompartmental knee arthroplasty to a total knee arthroplasty: can we achieve a primary result. Bone Joint J, 2017, 99-B(1 Supple A): 65-69.
6. Haughom BD, Schairer WW, Hellman MD, et al. An analysis of risk factors for short-term complication rates and increased length of stay following unicompartmental knee arthroplasty. HSS Journal, 2015, 11(2): 112-116.
7. Jin KL, Kim HJ, Park JO, et al. Inferior outcome of revision of unicompartmental knee arthroplasty to total knee arthroplasty compared with primary total knee arthroplasty: systematic review and meta-analysis. Knee Surgery Sports Traumatology Arthroscopy, 2018, 26(11): 3403-3418.
8. Edmondson MC, Isaac D, Wijeratna M, et al. Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term. J Orthop Surg Res, 2011, 6(1): 52.
9. Chatellard R, Sauleau V, Colmar M, et al. Medial unicompartmental knee arthroplasty: Does tibial component position influence clinical outcomes and arthroplasty survival. Orthopaedics & Traumatology: Surgery & Research, 2013, 99(4): S219-S225.
10. Assor M, Aubaniac JM. Influence of rotatory malposition of femoral implant in failure of unicompartmental medial knee prosthesis. Rev Chir Orthop Reparatrice Appar Mot, 2006, 92(5): 473-484.
11. 马路遥, 郭万首, 张启栋. 胫骨假体后倾对 Oxford 单髁关节置换术后短期临床结果的影响. 中华外科杂志, 2017, 55(6): 430-434.
12. 孔祥朋, 任鹏, 倪明, 等. 全膝关节置换术中三阶段关节腔周围注射鸡尾酒与股神经阻滞镇痛效果的比较. 中国骨与关节杂志, 2016, 5(10): 752-756.
13. 孔祥朋, 王岩, 柴伟, 等. 人工全髋关节置换术中应用组织胶水与传统缝合法的比较研究. 中国修复重建外科杂志, 2016, 30(12): 1467-1471.
14. Shakespeare D, Ledger M, Kinzel V. Accuracy of implantation of components in the Oxford knee using the minimally invasive approach. Knee, 2005, 12(6): 405-409.
15. Gulati A, Chau R, Simpson DJ, et al. Influence of component alignment on outcome for unicompartmental knee replacement. Knee, 2009, 16(3): 196-199.
16. Kang KT, Son J, Baek C, et al. Femoral component alignment in unicompartmental knee arthroplasty leads to biomechanical change in contact stress and collateral ligament force in knee joint. Arch Orthop Trauma Surg, 2018, 138(4): 563-572.
17. Hurst JM, Berend KR, Adams JB, et al. Radiographic comparison of mobile-bearing partial knee single-peg versus twin-peg design. J Arthroplasty, 2015, 30(3): 475-478.
18. White SH, Roberts S, Kuiper JH. The twin peg Oxford knee—medium term survivorship and surgical principles. Knee, 2018, 25(2): 314-322.
19. 贾笛, 李彦林, 王国梁, 等. 利用计算机辅助技术分析膝关节单髁置换术翻修原因. 中国修复重建外科杂志, 2016, 30(1): 119-122.
20. Kim KT, Lee S, Lee JI, et al. Analysis and treatment of complications after unicompartmental knee arthroplasty. Knee Surg Relat Res, 2016, 28(1): 46-54.
21. Mohammad HR, Strickland L, Hamilton TW, et al. Long-term outcomes of over 8,000 medial Oxford phase 3 unicompartmental knees—a systematic review. Acta Orthopaedica, 2017, 89(3): 101-107.
22. Hernigou P, Deschamps G. Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res, 2004, (423): 161-165.
23. Epinette JA, Brunschweiler B, Mertl P, et al. Unicompartmental knee arthroplasty modes of failure: wear is not the main reason for failure: a multicentre study of 418 failed knees. Orthop Traumatol Surg Res, 2012, 98(6 Suppl): S124-S130.
24. Pandit H, Jenkins C, Gill HS, et al. Minimally invasive Oxford phase 3 unicompartmental knee replacement: results of 1000 cases. J Bone Joint Surg (Br), 2011, 93(2): 198-204.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of accuracy of phase 3 Oxford prosthesis positioning on short-term effectiveness of unicompartmental knee arthroplasty

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