Serdar Kamil ÇEPNİ, Armağan ARSLAN, Halil POLAT, Atilla YALÇIN, Atilla Sancar PARMAKSIZOĞLU

Mid-term results of Oxford Phase 3 unicompartmental knee arthroplasty in obese patients

Amaç: Çalışmanın amacı, Oxford Faz 3 unikompartmantal diz protezi (UDP) yapılan obez hastaların orta dönemdeki protez sağ kalımlarını, lateral kompartmanda artroz gelişimini ve fonksiyonel sonuçlarını değerlendirmekti. Çalışma planı: Ocak 2005 ile Aralık 2010 tarihleri arasında izole medial osteoartrit tanısı ile hareketli taşıyıcılı Oxford Faz 3 UDP uygulanan ve cerrahi öncesi vücut kitle indeksi 30’un üstünde olan 67 hasta çalışmaya alındı. Hastaların cerrahi öncesi ve sonrası eklem hareket açıklıkları (EHA), diz skorlamaları (Hospital for Special Surgery, HSS ve Oxford diz skoru) karşılaştırıldı. Ayrıca, son kontrollerinde protezleri Oxford radyolojik değerlendirme kriterlerine göre değerlendirildi. Bulgular: Hastaların ortalama yaşı 61 idi. Hastalar ortalama 67.5 ay süreyle takip edildi. Üç hastada (%4.5) gelişen insert çıkığı dışında ek komplikasyon görülmedi. Cerrahi sonrası hastaların EHA, HSS ve Oxford diz skorlamalarında belirgin düzelme olduğu görüldü (p

Obez hastalarda Oxford Faz 3 unikompartmantal diz artroplastisinin orta dönem sonuçları

Objective: The aim of this study was to evaluate the mid-term outcomes of Oxford Phase 3 unicompartmental knee arthroplasty (UKA) in obese patients in terms of prosthesis survival, progression of lateral compartment arthrosis and functional outcomes. Methods: The study included 67 patients, with a body mass index over 30, treated with mobile bearing Oxford Phase 3 UKA for isolated medial osteoarthritis between January 2005 and December 2010. Preoperative and postoperative knee range of motion (ROM) and knee scores (Hospital for Special Surgery, HSS and Oxford knee scores) were compared. Additionally, prostheses were evaluated using Oxford radiographic evaluation criteria at the final follow-up. Results: Mean age was 61 years and mean follow-up was 67.5 months. Insert dislocation occurred in 3 patients (4.5%). Postoperative knee ROM, HSS and Oxford knee scores were significantly improved (p<0.05). There was no sign of prosthesis failure or lateral compartment arthrosis in radiographic evaluation at the final follow-up. Conclusion: Oxford Phase 3 UKA with mobile bearing has good mid-term results in obese patients over 60 years of age

___

1. Edmondson MC, Isaac D, Wijeratna M, Brink S, Gibb P, Skinner P. Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term. J Orthop Surg Res 2011;6:52. CrossRef
2. Labek G, Sekyra K, Pawelka W, Janda W, Stöckl B. Out- come and reproducibility of data concerning the Oxford unicompartmental knee arthroplasty: a structured litera- ture review including arthroplasty registry data. Acta Or- thop 2011;82:131-5. CrossRef
3. Mercier N, Wimsey S, Saragaglia D. Long-term clinical results of the Oxford medial unicompartmental knee ar- throplasty. Int Orthop 2010;34:1137-43. CrossRef
4. W-Dahl A, Robertsson O, Lidgren L, Miller L, Davidson D, Graves S. Unicompartmental knee arthroplasty in pa- tients aged less than 65. Acta Orthop 2010;81:90-4. CrossRef
5. Heck DA, Marmor L, Gibson A, Rougraff BT. Unicom- partmental knee arthroplasty. A multicenter investigation with long-term follow-up evaluation. Clin Orthop Relat Res 1993;286:154-9.
6. Insall JN, Hood RW, Flawn LB, Sullivan DJ. The total condylar knee prosthesis in gonarthrosis. A five to nine- year follow-up of the first one hundred consecutive re- placements. J Bone Joint Surg Am 1983;65:619-28.
7. Ridgeway SR, McAuley JP, Ammeen DJ, Engh GA. The effect of alignment of the knee on the outcome of uni- compartmental knee replacement. J Bone Joint Surg Br 2002;84:351-5. CrossRef
8. Verdonk R, Cottenie D, Almqvist KF, Vorlat P. The Oxford unicompartmental knee prosthesis: a 2-14 year follow-up. Knee Surg Sports Traumatol Arthrosc 2005;13:163-6.
9. Berger RA, Meneghini RM, Sheinkop MB, Della Valle CJ, Jacobs JJ, Rosenberg AG, et al. The progression of patello- femoral arthrosis after medial unicompartmental replace- ment: results at 11 to 15 years. Clin Orthop Relat Res 2004;428:92-9. CrossRef
10. Steele RG, Hutabarat S, Evans RL, Ackroyd CE, New- man JH. Survivorship of the St Georg Sled medial uni- compartmental knee replacement beyond ten years. J Bone Joint Surg Br 2006;88:1164-8. CrossRef
11. Dacre JE, Cushnaghan J, Jack MJ, Kirwan JR, Dieppe PA. Knee X-rays: should we take them lying down? Br J Rheu- matol 1991;30(Suppl 1):3. 12.
12. Squire MW, Callaghan JJ, Goetz DD, Sullivan PM, Johnston RC. Unicompartmental knee replacement. A minimum 15 year followup study. Clin Orthop Relat Res 1999;367:61-72. CrossRef
13. Cartier P, Sanouiller JL, Grelsamer RP. Unicompartmen- tal knee arthroplasty surgery. 10-year minimum follow-up period. J Arthroplasty 1996;11:782-8. CrossRef
14. Weale AE, Murray DW, Crawford R, Psychoyios V, Bonomo A, Howell G, et al. Does arthritis progress in the retained compartments after ‘Oxford’ medial unicom- partmental arthroplasty? A clinical and radiological study with a minimum ten-year follow-up. J Bone Joint Surg Br 1999;81:783-9. CrossRef
15. Kozinn SC, Marx C, Scott RD. Unicompartmental knee arthroplasty. A 4.5-6-year follow-up study with a metal-backed tibial component. J Arthroplasty 1989;4 Suppl:S1-10. CrossRef
16. Deshmukh RV, Scott RD. Unicompartmental knee ar- throplasty: long-term results. Clin Orthop Relat Res 2001;392:272-8. CrossRef
17. Stockelman RE, Pohl KP. The long-term efficacy of uni- compartmental arthroplasty of the knee. Clin Orthop Relat Res 1991;271:88-95.
18. Engh GA, McAuley JP. Unicondylar arthroplasty: an op- tion for high-demand patients with gonarthrosis. Instr Course Lect 1999;48:143-8.
19. Berger RA, Nedeff DD, Barden RM, Sheinkop MM, Ja- cobs JJ, Rosenberg AG, et al. Unicompartmental knee ar- throplasty. Clinical experience at 6- to 10-year followup. Clin Orthop Relat Res 1999;367:50-60.
20. Murray DW, Goodfellow JW, O’Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 1998;80:983-9. CrossRef
21. Murray DW, Pandit H, Weston-Simons JS, Jenkins C, Gill HS, Lombardi AV, et al. Does body mass index af- fect the outcome of unicompartmental knee replacement? Knee 2013;20:461-5. CrossRef