Midterm functional outcomes and survivorship of Oxford cemented medial unicompartmental knee arthroplasty: A comprehensive analysis of the Indian scenario

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-27 DOI:10.1016/j.jcot.2025.103115

Amyn M. Rajani, Anmol RS. Mittal, Urvil A. Shah, Vishal U. Kulkarni, Rishab Dubey

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Abstract

Background

Isolated anteromedial osteoarthritis (AMOA) is prevalent in 46.94 % of the Indian population undergoing primary total knee arthroplasty (TKA). Compared with TKA, medial unicompartmental knee arthroplasty (UKA) has shown superior functional outcomes in such patients but remains underutilised in India. This study aimed to assess the midterm functional and clinical outcomes, long-term survival, and complications of cemented Oxford UKA in Indian patients with isolated AMOA and to analyse the factors influencing its acceptance and success.

Methods

This prospective, observational study was conducted at a single center from September 2014 to September 2024 and included 191 knees from 180 patients. Preoperative and follow-up assessments included clinical and patient-reported outcome measures (PROMs), such as the American Knee Society (KSS), the Oxford Knee Score (OKS), and the forgotten joint score (FJS). The complication and revision rates were also monitored.

Results

Significant improvement in all PROMs and clinical outcomes was observed at 5 years post-surgery. The mean preoperative KSS improved from 48.2 to 88.3, the mean OKS improved from 28.7 to 40.5, the mean FJS improved from 38.1 to 73.6, and the mean ROM improved from 91.5° to 120.4° at 5 years post-surgery (p < 0.001). Majority patients could squat, sit on the floor, and sit cross-legged within one-year post-surgery. The 5-year survivorship was 96.85 %. Six knees required revision surgery, with progression of osteoarthritis to the lateral compartment being the most common cause. The frequency of complications was inversely related to surgeon experience and case volume.

Conclusions

Cemented Oxford UKA yields excellent clinical and functional outcomes for Indian patients with isolated AMOA, with 96.85 % 5-year survival and significant improvements in PROMs and range of motion. The procedure enables patients to resume traditional activities requiring a high range of motion. Enhanced patient and surgeon education is needed to increase the acceptance of UKA in India.

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牛津骨水泥内侧单室膝关节置换术的中期功能结局和生存率：对印度情况的综合分析

背景：孤立性前内侧骨关节炎（AMOA）在印度接受首次全膝关节置换术（TKA）的人群中普遍存在46.94%。与TKA相比，内侧单室膝关节置换术（UKA）在这类患者中显示出更好的功能效果，但在印度仍未得到充分利用。本研究旨在评估印度孤立性AMOA患者的中期功能和临床结局、长期生存和并发症，并分析影响其接受度和成功的因素。方法本前瞻性观察性研究于2014年9月至2024年9月在单中心进行，纳入180例患者的191个膝关节。术前和随访评估包括临床和患者报告的结果测量（PROMs），如美国膝关节协会（KSS）、牛津膝关节评分（OKS）和遗忘关节评分（FJS）。同时监测并发症和翻修率。结果术后5年，所有PROMs和临床结果均有显著改善。术后5年平均KSS从48.2改善到88.3，平均OKS从28.7改善到40.5，平均FJS从38.1改善到73.6，平均ROM从91.5°改善到120.4°(p <；0.001)。大多数患者术后一年内可以下蹲、坐在地板上、盘腿坐。5年生存率为96.85%。六个膝关节需要翻修手术，骨关节炎进展到外侧腔室是最常见的原因。并发症的发生频率与手术经验和病例量呈负相关。结论：改良的Oxford UKA对印度孤立性AMOA患者具有良好的临床和功能效果，5年生存率为96.85%，PROMs和活动范围均有显著改善。该手术使患者能够恢复需要大范围运动的传统活动。需要加强患者和外科医生的教育，以提高印度对UKA的接受度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.