Does robotic-assisted unicompartmental knee arthroplasty improve alignment and outcomes?

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of competing interest The author, Rhett MacNeille, declares that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tsun Law, MD, MBA reports a relationship with Arthrex Inc that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Martin Roche, MD reports a relationship with Stryker Orthopaedics that includes: consulting or advisory and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The authors declare the following financial interests/personal relationships that may be considered as potential competing interests: James C Chow, MD, reports a relationship with Smith & Nephew Inc. and MicroPort Orthopedics Inc. that includes consulting or advisory, speaking and lecture fees, and travel reimbursement and a relationship with Vomaris Innovations, Inc., Stryker Orthopaedics, and Pfizer Inc. that includes equity or stocks. Martin Roche, MD, reports a relationship with Stryker Orthopaedics that includes consulting or advisory and speaking and lecture fees. Tsun Yee Law, MD, MBA, reports a relationship with Arthrex Inc. that includes consulting or advisory. Rhett MacNeille declares that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article. 8. Bone Joint J. 2020 Aug;102-B(8):1033-1040. doi: 10.1302/0301-620X.102B8.BJJ-2019-1330.R2. Oxford domed lateral unicompartmental knee arthroplasty. Kennedy JA(1), Mohammad HR(1), Yang I(1), Mellon SJ(1), Dodd CAF(2), Pandit HG(1)(3), Murray DW(1)(2). Author information: (1)Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK. (2)Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. (3)Leeds Institute of Rheumatic and Musculoskeletal Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK. AIMS: To report mid- to long-term results of Oxford mobile bearing domed lateral unicompartmental knee arthroplasty (UKA), and determine the effect of potential contraindications on outcome. METHODS: A total of 325 consecutive domed lateral UKAs undertaken for the recommended indications were included, and their functional and survival outcomes were assessed. The effects of age, weight, activity, and the presence of full-thickness erosions of cartilage in the patellofemoral joint on outcome were evaluated. RESULTS: Median follow-up was seven years (3 to 14), and mean age at surgery was 65 years (39 to 90). Median Oxford Knee Score (OKS) was 43 (interquartile range (IQR) 37 to 47), with 260 (80%) achieving a good or excellent score (OKS > 34). Revisions occurred in 34 (10%); 14 (4%) were for dislocation, of which 12 had no recurrence following insertion of a new bearing, and 12 (4%) were revised for medial osteoarthritis (OA). Ten-year survival was 85% (95% confidence interval (CI) 79 to 90, at risk 72). Age, weight, activity, and patellofemoral erosions did not have a significant effect on the clinical outcome or survival. CONCLUSION: Domed lateral UKA provides a good alternative to total knee arthroplasty (TKA) in the management of lateral compartment OA. Although dislocation is relatively easy to treat successfully, the dislocation rate of 4% is high. It is recommended that the stability of the bearing is assessed intraoperatively. If the bearing can easily be displaced, the fixed rather than the mobile bearing version of the Oxford lateral tibial component should be inserted instead. Younger age, heavier weight, high activity, and patellofemoral erosions did not detrimentally affect outcome, so should not be considered contraindications. Cite this article: Bone Joint J 2020;102-B(8):1033-1040. DOI: 10.1302/0301-620X.102B8.BJJ-2019-1330.R2