Abstract
Unicompartmental knee replacement (UKR) is an increasingly popular alternative to total knee replacement in medial compartment disease. Early problems include unexplained pain, stiffness, infection and technical errors leading to dislocation of bearing or fracture. This study is the first to highlight re-intervention as an outcome measure when assessing the success of a partial joint replacement.
All Oxford UKRs undertaken at ROH during November 2002 and December 2007 were reviewed to identify patients who required a further procedure.
383 UKRs were implanted. 21 (5.5%) patients underwent further re-intervention. Twelve (3.1%) were for persistent post-operative pain, three (0.8%) for stiffness and six (1.6%) had a combination of symptoms. one re-intervention was for a tibial plateau fracture. Initial re-interventions included eleven arthroscopies and three manipulations.
Nine (2.4%) patients subsequently underwent revision procedures, eight to a total knee replacement with one revision to a fixed bearing unicompartmental prosthesis. There were no revisions for infection. Manipulation improved stiffness in all the patients. Outcome following re-interventions for persistent pain were less predictable. Arthroscopy improved symptoms in only 36% of patients but eight of the nine (88.9%) patients that were formally revised had an improvement in symptoms.
Our early re-intervention rate of 5.5% and the out-come of subsequent surgery provides a valuable evidence based resource to discuss potential post operative expectations and complications with patients awaiting an Oxford UKR.
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
