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MINIMALLY INVASIVE OXFORD UNICOMPARTMENTAL KNEE ARTHROPLASTY: FUNCTIONAL RESULTS AT ONE YEAR AND THE EFFECT OF SURGICAL EXPERIENCE



Abstract

Introduction: A new procedure has been recently adopted to implant the Oxford medial unicompartmental arthroplasty (UCA). All cases are now implanted through a short incision without dislocation of the patella. The aims of this study were to assess the one-year results using this new technique and to determine if the outcome is dependent on surgical experience.

Method: The first 104 Oxford UCA’s (Phase 3) implanted by six surgeons under the care of two consultants were reviewed at one year. All operations were performed using the new technique. The average age at surgery was 68 years. All knees were scored pre-operatively and at review with the American Knee Society score. The cohort was divided into two groups; the first ten cases for each surgeon were included in a ‘learning’ group, whilst the remaining cases were included in an ‘experienced’ group.

Results: Overall the average ‘knee score’ improved from 37 points to 94 and the average ‘functional score’ from 50 points to 92. Average maximum flexion improved from 117° to 131°. The ‘knee score’ for the ‘learning’ group was 91 points. This was significantly less (p = 0.008) than the score of the ‘experienced’ group (96 points).

Conclusions: These results are significantly better than the best historical results of the Oxford (UCA), performed through an open approach with dislocation of the patella.

Despite impressive overall results at one year, lower knee scores were associated with a surgeons ‘learning curve’. After this ‘learning curve’, increased surgical experience led to further improvement with 90% achieving an excellent result, 8% a good, 2% a fair and 0% a poor result.

The abstracts were prepared by Nico Verdonschot. Correspondence should be addressed to him at Orthopaedic Research Laboratory, University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.