Early Results of Oxford Mobile Bearing Medial Unicompartmental Knee Replacement (UKR) with the Microplasty Instrumentation: An Indian Experience.

Abstract

Oxford medial unicompartmental knee replacement (UKR) is indicated in patients with anteromedial osteoarthritis (AMOA) of the knee. Microplasty (MP) instrumentation was introduced in 2012 as an improvement over phase 3 instrumentation. Advantages of this instrumentation include conservative tibial cut, decreased tibial re-cut rate and improved component alignment. We report the results of UKR with the new instrumentation in a consecutive series with a minimum follow-up of 2 years. A prospective study of 115 cemented medial Oxford UKRs implanted in 89 patients was done. Post-operative alignment of the tibial and femoral components was analysed. Patient reported outcome measures were recorded using Oxford Knee Score (OKS) and the American Knee Society Score (KSS). Tegner Activity Scale (TAS) was used to record the activity level. 115 consecutive medial Oxford UKRs were studied. All patients were followed up annually in this prospective ethically approved study. The mean follow-up was 36 months and the minimum follow-up was 25 months. No patient died and none were lost to follow-up. At the final follow-up, the average OKS of the cohort was 39.5 (SD: 5.7). 91.2 % of the patients had good or excellent OKS with only 3.5 % reporting poor OKS. The overall limb alignment was 4.80 varus (0 - 140 varus). Tibia was recut in 5.2 % of cases. Median bearing size was 3 (range: 3 to 6). There was one case of bearing dislocation and one case of aseptic tibial loosening. This is the first study to report results of MP instrumentation at a minimum follow-up of 2 years. Our study indicates that the new instrumentation results in reliable and accurate implantation of femoral and tibial components in majority of the cases, with a decrease in number of alignment outliers, and also a reduced rate of bearing dislocation.