Elsevier

The Knee

Volume 13, Issue 4, August 2006, Pages 296-300
The Knee

Sporting and physical activity following Oxford medial unicompartmental knee arthroplasty

https://doi.org/10.1016/j.knee.2006.03.004Get rights and content

Abstract

The purpose of this study was to evaluate and assess the sporting and physical activities of patients who had undergone an Oxford medial unicompartmental knee arthroplasty (UKA). Seventy-six patients who underwent a UKA between 2000 and 2003 were reviewed. Demographic data such as age, sex and comorbidities were recorded. University of California Los Angeles (UCLA) activity level ratings and Oxford knee scores were determined for each patient. The sporting and physical activities of all patients' pre- and post-operatively were recorded. The mean age of patients was 64 years (range 49–81) at surgery and 66 years (range 53–82) at review. The mean follow up time was 18 months (range 4–46). Following surgery there was a significant improvement in UCLA activity level scores from 4.2 to 6.5 (Wilcoxon Matched-pairs Signed-rank Test, p < 0.01). Forty-two patients (64%) regularly participated in sport before they became symptomatic with significant knee pain, and thirty-nine patients (59%) regularly participated in sports after surgery. In total 93% of patients successfully returned to their regular sporting and physical activities following surgery. The published long-term survivorship of the Oxford UKA has given surgeons increasing confidence to use the prosthesis on a younger generation of patients. Our study has demonstrated that this population of patients is extremely active. A more detailed study is required to evaluate the long-term effects of sporting activity on the Oxford UKA.

Introduction

For more than 30 years total knee arthroplasty (TKA) has been the gold standard for the management of advanced osteoarthritis of the knee. The principal goals of surgery are to decrease pain and reduce deformity, both of which aim to improve function. At the beginning of the new millennium, restoration of function is often a primary reason for knee arthroplasty [1]. Increasingly the desire for improvement in function often includes an aspiration to return to sporting activity. The participation in sports following total knee arthroplasty has been investigated and a few studies have looked at physical activities of such patients [2], [3], [4].

The advent of the Oxford unicompartmental knee arthroplasty (UKA) has added a new dimension to the management of isolated medial compartment osteoarthritis of the knee. The Oxford UKA is one of the most successful unicompartmental knee arthroplasties with published survivorship of 98% at 10 years [5], [6]. This is a cruciate preserving procedure that can be performed easily with a minimal access approach. The post-operative recovery is rapid and the range of movement of unicompartmental knee replacements is better than TKA [7]. All of these features of the Oxford UKA reduce pain and improve function whilst at the same time preserving stability of the knee.

A younger and more active population of patients is now undergoing Oxford UKA. To date we have found no study in the published literature that has looked at the sporting activities of this group. In addition the recommendations for physical activities of such patients are poorly defined. The current study was conducted to evaluate the sporting and physical activities, and analyze functional outcomes of patients undergoing Oxford UKA for isolated medial compartment osteoarthritis of the knee.

Section snippets

Patients and methods

Between 2000 and 2003, 76 consecutive patients who underwent an Oxford UKA at our hospital were studied. The study was approved by our Local Research Ethical Committee. Nine patients who were lost to follow up and one patient, who died at 12 months following surgery due to metastatic bowel cancer, were excluded from the study. Sixty-six patients were available for final review. Five patients had bilateral Oxford unicompartmental knee arthroplasties, giving a total of 71 knees. Simple demographic

Results

The mean age at surgery was 64 years (range 49–81) and 66 years (range 53–82) at review. The mean follow up time was 18 months (range 4–46). The male to female ratio was almost 1:1 (32 males and 34 females). There was no significant difference in the ages of patients who did and did not participate in sport following surgery (Mann-Whitney U-test, p = 0.77).

Discussion

In 2004, the mean life expectancy of our population is more than ever. People are more active and the prevalence of knee replacement surgery is increasing. One of the major success stories in modern knee surgery has been the management of isolated medial compartment osteoarthritis of the knee by UKA. The published long-term survivorship of the Oxford UKA has given us increasing confidence to use this prosthesis in younger patients. Our study has shown that this population of patients is very

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