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General Orthopaedics

EARLY OUTCOMES FOR THE OXFORD DOMED LATERAL UNICOMPARTMENTAL KNEE REPLACEMENT

South West Orthopaedic Club (SWOC)



Abstract

The Oxford unicompartmental knee replacement (UKR) was introduced in 1976 with good results. Mobile bearings in the lateral compartment have been associated with unacceptably high bearing dislocation rates, due to greater movement between the lateral femoral condyle and tibia, and the lateral collateral ligament's laxity in flexion. The new domed implant is designed to counter this with a convex tibial prosthesis and a fully-congruent, bi-concave mobile bearing allowing a full range-of-movement (ROM), minimising dislocation risk and bearing wear.

We present complication rates and clinical outcomes for a consecutive series of our first 20 patients undergoing Oxford domed lateral UKR, between June 2006 and August 2009, with minimum 6-month follow-up. There was one unrelated death (31 months post-UKR) and one postop MI. We had no bearing dislocations, infections or loosening nor other complications. All patients had post-op Oxford Knee Scores; eleven had pre-op scores and demonstrated a significant improvement – mean pre-op 22.75 to post-op 35.45 (p=0.01). All achieved full extension with average ROM 116°, mean change in ROM was –2.6°(p=0.6).

This study adds to previous work in confirming a low level of complications with this new procedure (including the early learning curve), particularly bearing dislocation and demonstrates excellent functional outcomes.