Reduced 5-Year Risk for Revision of the Oxford UKA Using New Instrumentation versus Conventional Instrumentation: A Registry Study of 12,867 UKAs

Stephan J. van Langeveld; Stein J. Janssen; Koen L. M. Koenraadt; Leon H. G. J. Elmans; Liza N. van Steenbergen; Rutger C. I. van Geenen

doi:10.1055/a-1946-6892

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2023; 36(14): 1447-1453
DOI: 10.1055/a-1946-6892

Original Article

Reduced 5-Year Risk for Revision of the Oxford UKA Using New Instrumentation versus Conventional Instrumentation: A Registry Study of 12,867 UKAs

Authors

Stephan J. van Langeveld

¹Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Breda, The Netherlands
Stein J. Janssen

²Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands
Koen L. M. Koenraadt

¹Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Breda, The Netherlands
Leon H. G. J. Elmans

¹Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Breda, The Netherlands
Liza N. van Steenbergen

³Dutch Arthroplasty Register (LROI),'s-Hertogenbosch, The Netherlands
Rutger C. I. van Geenen

¹Department of Orthopaedic Surgery, FORCE (Foundation for Orthopaedic Research Care and Education), Amphia Hospital, Breda, The Netherlands

Abstract

Microplasty instrumentation was introduced for a more consistent surgical implantation technique, especially component alignment and tibial resection level, of the Oxford medial unicompartmental knee arthroplasty (UKA) and thereby aims to improve UKA survival. This study aimed to assess the 5-year risk for revision and reasons for revision of the Oxford medial UKA using the new instrumentation (Microplasty) with its predecessor, that is, conventional instrumentation (Phase 3). Data of all medial UKAs from the Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Implantaten) between 2007 and 2019 were collected. Type of instrumentation was divided into new (Microplasty) and conventional instrumentation. Kaplan–Meier analysis was performed to calculate 5-year cumulative revision percentage with any reason for revision as end point. A multivariable Cox regression with outcome revision of UKA adjusted for age, gender, American Society of Anesthesiologists score, surgical history, and type of fixation was performed. Additionally, reasons for revision at 3-year were assessed and tested through Fisher's exact tests. A total of 12,867 Oxford medial UKAs, 8,170 using new and 4,697 using conventional instrumentation, were included. The 5-year revision percentage was 9.2% (95% confidence interval [CI]: 8.4–10.1%) for UKAs using the conventional and 6.1% (95% CI: 5.4–6.7%) for new instrumentation. The adjusted hazard ratio for revision at 5-year follow-up was 0.74 (95% CI: 0.63–0.87) in favor of UKAs using the new instrumentation. Malalignment was more frequently registered as reason for revision in UKAs using the conventional compared with the new instrumentation (16% versus 7.5%; p = 0.001). Our results show a reduced 5-year risk for revision of the medial Oxford UKAs using the new compared with the conventional instrumentation. This might be the result of a lower revision rate for malalignment in UKAs using the new instrumentation.

Keywords

Microplasty instrumentation - unicompartmental knee arthroplasty - revision - reason for revision

Full Text

References

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