Sporting and physical activity following Oxford medial unicompartmental knee arthroplasty
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
References (23)
- et al.
Participation in sports after hip and knee arthroplasty: Review of literature and Survey of surgeon preferences
Mayo Clin Proc
(1995) - et al.
Total knee arthroplasty in active golfers
J Arthroplast
(1993) - et al.
Assessing activity in joint replacement patients
J Arthroplast
(1998) - et al.
Revision of unicondylar knee replacements to total knee replacement
The Knee
(1995) - et al.
Revision total knee arthroplasty after unicompartmental femorotibi prosthesis: 54 cases
Rev Chir Orthop Repar Appar Mot
(2004) - et al.
Participation in sports after total knee replacement
Am J Sports Med
(1998) - et al.
Tennis after total knee arthroplasty
Am J Sports Med
(2002) - et al.
The Oxford medial unicompartmental arthroplasty. A ten-year survival study
J Bone Jt Surg (Br)
(1998) - et al.
Ten-year survival results of Oxford mobile bearing unicompartmental knee arthroplasty in young patients
- et al.
Unicompartmental versus total knee arthroplasty in the same patient: a comparative study
Clin Orthop
(1991)
Questionnaire on the perceptions of patients about total knee replacement
J Bone Jt Surg
Cited by (97)
Retrospective analysis of return to impact sport after medial unicompartmental knee arthroplasty based on a cohort of 92 patients
2023, Revue de Chirurgie Orthopedique et TraumatologiqueRetrospective analysis of return to impact sport after medial unicompartmental knee arthroplasty based on a cohort of 92 patients
2023, Orthopaedics and Traumatology: Surgery and ResearchComparison of Long-Term Survival Analysis Between Open-Wedge High Tibial Osteotomy and Unicompartmental Knee Arthroplasty
2021, Journal of ArthroplastyCitation Excerpt :The postmatching comparison showed that the two cohorts selected had similar demographic characteristics for matched parameters (Table 1). Several studies have compared the outcomes for various clinical parameters between UKA and HTO procedures [6,8,33–35]. Some studies also reported that the differences in clinical outcomes were not statistically significant between the two procedures [2,5,30,36].
Sports activity and patient-related outcomes after fixed-bearing lateral unicompartmental knee arthroplasty
2021, KneeCitation Excerpt :In their study the frequency and session length did not change postoperatively [17]. Looking at medial UKA, our results are in line with the reported frequencies and sessions lengths [22,28,29]. In the present study, PROMs were also evaluated in order to survey sporting activity.
Minimally invasive lateral unicompartmental knee replacement: Early results from an independent center using the Oxford fixed lateral prosthesis
2020, KneeCitation Excerpt :With the results of the Tegner activity score as well as the UCLA Score, it could be demonstrated that most patients are physically active in their daily routine and participate to some degree in sports or physical activities. Similar results were demonstrated by several previous studies on mobile-bearing UKR in the medial as well as in the lateral compartment [35–37]. The major limitations of the present study include the short clinical follow-up period with a minimum follow-up of 12 months and a mean follow-up of two years, the relatively small number of patients as well as the retrospective study design.