Abstract
BackgroundThe use of Oxford uni-compartmental knee arthroplasty (UKA) has rapidly increased worldwide,however,the relevance of younger patients for postoperative function after Oxford UKA remains unclear. The main purpose of our study is to clarify the effectivemess of Oxford UKA in the younger Chinese patients with anteromedial osteoarthritis (AMOA).MethodsWe retrospectively enrolled 252 consecutive patients who underwent Oxford UKA for AMOA with a minimum follow-up of 5 years between March 2013 and December 2016. The patients were divided into the younger (≤60 years) and elderly (> 60 years) age groups. The demographic data and surgery variables were recorded and compared. Patient satisfaction grade, range of motion (ROM), Oxford knee score (OKS), Hospital for Special Surgery (HSS) score, Western Ontario and McMaster (WOMAC) Universities Osteoarthritis Index score and postoperative complications were recorded. The 5-year survival of the implants were also compared with TKA revision as the endpoint.ResultsA total of 252 consecutive patients were recruited, including 96 aged 60 years or less and 156 aged over 60 years. The mean follow-up duration in the younger and elderly groups were 73.6 months (SD,standard deviation, 4.1) and 74.7 months (SD 6.2) respectively. Patient satisfaction rate was high in both groups (P = 0.805). Furthermore, no significant differences were observed in postoperative ROM(P = 0.299), OKS(P = 0.117), HSS(P = 0.357) and WOMAC scores(P = 0.151) between the younger and elderly groups (P>0.05). However, the incidence of joint stiffness (P = 0.033) and delayed wound dehiscence (P = 0.026) were significantly different between both groups. Five-year implant survival without revision were also similar in both groups (96.9% vs 97.4%, P = 0.871), and that for the entire cohort was 97.2% (95% CI 95.4–99.6).ConclusionOxford UKA for AMOA demonstrated favorable results in younger patients aged ≤60 years at a minimum 5-year follow-up in terms of patient satisfaction, functional outcomes, implant survival and postoperative complications. Therefore, younger patients might not be considered as an absolute contraindication to Oxford UKA.
Highlights
Oxford uni-compartmental knee arthroplasty (UKA) is a minimally invasive surgery that replaces the surface of the knee joint, and is an ideal treatment for isolated unicompartmental osteoarthritis (OA)
Goodfellow et al [12, 13] established the indications for Oxford UKA based on the anteromedial osteoarthritis (AMOA) and spontaneous osteonecrosis of the knee (SONK)
Two hundred and fifty-two consecutive patients with a minimum 5-year follow-up were enrolled in this study, of which 96 were aged 60 years or younger, and 156 were over 60 years
Summary
Oxford uni-compartmental knee arthroplasty (UKA) is a minimally invasive surgery that replaces the surface of the knee joint, and is an ideal treatment for isolated unicompartmental osteoarthritis (OA). The indications for UKA have been expanded in recent years [3,4,5,6], and the high survival rates of the implants have been demonstrated [7,8,9,10] Based on their experience with fixed-bearing devices, Kozinn and Scott [11] proposed age greater than 60 years, weight less than 180 pounds (82 kg), high activity requirement, patellofemoral joint or lateral compartment degeneration, cartilage calcium deposition, preoperative flexion angle > 90°, flexion contracture < 5°, and angular knee deformity < 15° as the indications for Oxford UKA. The main purpose of our study is to clarify the effectivemess of Oxford UKA in the younger Chinese patients with anteromedial osteoarthritis (AMOA)
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