Adam M Ali1, Hemant Pandit2, Alexander D Liddle1, Cathy Jenkins3, Stephen Mellon1, Christopher A F Dodd3, David W Murray4. 1. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom. 2. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; Nuffield Orthopaedic Centre, Oxford, United Kingdom. 3. Nuffield Orthopaedic Centre, Oxford, United Kingdom. 4. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; Nuffield Orthopaedic Centre, Oxford, United Kingdom. Electronic address: david.murray@ndorms.ox.ac.uk.
Abstract
BACKGROUND: High levels of activity are considered to be a contraindication to unicompartmental knee replacement (UKR) and are not recommended after UKR. To determine if these recommendations should apply to the mobile-bearing Oxford UKR, this study assessed the effect of post-operative activity level on the outcome of this device. METHODS: The outcome of the first 1000 Phase 3 cemented Oxford UKRs implanted between 1998 and 2010 was assessed using survival analysis, the Oxford Knee Score (OKS) and the American Knee Society Objective (KSS-O) and Functional (KSS-F) Scores. Patients were grouped according to the maximum post-operative Tegner Activity Score. RESULTS: The mean follow-up was 6.1 years (range 1 to 14). Overall, increasing activity was associated with superior survival (p=0.025). In the high activity group, with Tegner≥5 (n=115) 2.6% were revised and the 12-year survival was 97.3% (confidence interval (CI): 92.0% to 99.1%). In the low activity group, with Tegner≤4, (n=885) 4.3% were revised and the 12-year survival was 94.0% (CI: 91.4 to 95.8). The difference between the two groups was not significant (p=0.44). Although the final OKS and KSS-F were significantly better in the high activity group compared to the low activity group (OKS 45v40, KSS-F 95v78), there was no difference in the change in OKS or KSS-O. CONCLUSIONS: High activity does not compromise the outcome of the Oxford UKR and may improve it. Activity should not be restricted nor considered to be a contraindication.
RCT Entities:
BACKGROUND: High levels of activity are considered to be a contraindication to unicompartmental knee replacement (UKR) and are not recommended after UKR. To determine if these recommendations should apply to the mobile-bearing Oxford UKR, this study assessed the effect of post-operative activity level on the outcome of this device. METHODS: The outcome of the first 1000 Phase 3 cemented Oxford UKRs implanted between 1998 and 2010 was assessed using survival analysis, the Oxford Knee Score (OKS) and the American Knee Society Objective (KSS-O) and Functional (KSS-F) Scores. Patients were grouped according to the maximum post-operative Tegner Activity Score. RESULTS: The mean follow-up was 6.1 years (range 1 to 14). Overall, increasing activity was associated with superior survival (p=0.025). In the high activity group, with Tegner≥5 (n=115) 2.6% were revised and the 12-year survival was 97.3% (confidence interval (CI): 92.0% to 99.1%). In the low activity group, with Tegner≤4, (n=885) 4.3% were revised and the 12-year survival was 94.0% (CI: 91.4 to 95.8). The difference between the two groups was not significant (p=0.44). Although the final OKS and KSS-F were significantly better in the high activity group compared to the low activity group (OKS 45v40, KSS-F 95v78), there was no difference in the change in OKS or KSS-O. CONCLUSIONS: High activity does not compromise the outcome of the Oxford UKR and may improve it. Activity should not be restricted nor considered to be a contraindication.
Authors: David A Crawford; Joanne B Adams; Gerald R Hobbs; Michael J Morris; Keith R Berend; Adolph V Lombardi Journal: Arthroplast Today Date: 2021-08-23
Authors: Hasan Raza Mohammad; Stephen Mellon; Andrew Judge; Christopher Dodd; David Murray Journal: Knee Surg Sports Traumatol Arthrosc Date: 2021-02-12 Impact factor: 4.342