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.	盧明峰, 鐘露斌, 李澤暉, 等. 牛津單髁置換術與全膝關節置換術治療膝內側單間室骨關節炎的近期療效對比研究. 中華骨與關節外科雜志, 2016, 9(6): 476-479.
2.	文濤, 涂意輝, 薛華明, 等. 單髁置換術與全膝置換術的經濟效益分析. 中華關節外科雜志 (電子版), 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.	馬路遙, 郭萬首, 張啟棟. 脛骨假體后傾對 Oxford 單髁關節置換術后短期臨床結果的影響. 中華外科雜志, 2017, 55(6): 430-434.
12.	孔祥朋, 任鵬, 倪明, 等. 全膝關節置換術中三階段關節腔周圍注射雞尾酒與股神經阻滯鎮痛效果的比較. 中國骨與關節雜志, 2016, 5(10): 752-756.
13.	孔祥朋, 王巖, 柴偉, 等. 人工全髖關節置換術中應用組織膠水與傳統縫合法的比較研究. 中國修復重建外科雜志, 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.	賈笛, 李彥林, 王國梁, 等. 利用計算機輔助技術分析膝關節單髁置換術翻修原因. 中國修復重建外科雜志, 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. 盧明峰, 鐘露斌, 李澤暉, 等. 牛津單髁置換術與全膝關節置換術治療膝內側單間室骨關節炎的近期療效對比研究. 中華骨與關節外科雜志, 2016, 9(6): 476-479.
2. 文濤, 涂意輝, 薛華明, 等. 單髁置換術與全膝置換術的經濟效益分析. 中華關節外科雜志 (電子版), 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. 馬路遙, 郭萬首, 張啟棟. 脛骨假體后傾對 Oxford 單髁關節置換術后短期臨床結果的影響. 中華外科雜志, 2017, 55(6): 430-434.
12. 孔祥朋, 任鵬, 倪明, 等. 全膝關節置換術中三階段關節腔周圍注射雞尾酒與股神經阻滯鎮痛效果的比較. 中國骨與關節雜志, 2016, 5(10): 752-756.
13. 孔祥朋, 王巖, 柴偉, 等. 人工全髖關節置換術中應用組織膠水與傳統縫合法的比較研究. 中國修復重建外科雜志, 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. 賈笛, 李彥林, 王國梁, 等. 利用計算機輔助技術分析膝關節單髁置換術翻修原因. 中國修復重建外科雜志, 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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