title: Squatting Following Total Knee Arthroplasty Factors contributing to inherent varus alignment of lower limb in normal Asian adults: role of tibial plateau inclination. Minimally invasive Oxford medial unicompartmental knee arthroplasty. A note of caution! The results of Oxford unicompartmental knee arthroplasty in the United States Ten- to 15-year results of the Oxford Phase III mobile unicompartmental knee arthroplasty Mid‐term results of Oxford phase‐3 medial unicompartmental knee arthroplasty for medial arthritis in Chinese patients Unicompartmental knee arthroplasty compares favorably to total knee arthroplasty in the same patient. The clinical outcome of minimally invasive Phase 3 Oxford unicompartmental knee arthroplasty: a 15-year follow-up of 1000 UKAs. Oxford phase 3 unicompartmental knee replacement in Korean patients.
abstract: & NA ; This prospect i ve study was performed to investigate whether postoperative alternate flexion and extension splinting ( daily change in position of immobilization by splinting ) was useful in restoring full range of motion ( ROM )  after total knee arthroplasty as compared with continuous passive motion . The  alternate flexion and extension splinting group and the  continuous passive motion group were each composed of 34 knees .  Final ROM was measured at an average of 3.5 years postoperatively . Squatting was possible in 31 knees ( 45.6 % ) of the alternate flexion and extension  splinting group . The postoperative ROM of the osteoarthritic knees ( 131.8 ° ± 12.3 ° ) was significantly greater than that of the rheumatoid knees ( 121.9 ° ± 22.4 ° ) ( p < 0.05 ) . The postoperative ROM of the alternate flexion and extension splinting group ( 135.1 ° ± 11.9 ° ) also was significantly greater than that of the continuous passive motion group ( 120.0 ° ± 19.7 ° ) ( p < 0.01 ) . There was no statistically significant relationship between the posterior slope of tibial cutting and the postoperative ROM . It is suggested that alternate flexion and extension splinting is effective in restoring full ROM after total knee arthroplasty PURPOSE This prospect i ve study aim ed to evaluate radiographically , mechanical or hip-knee-ankle ( HKA ) axis in healthy , asymptomatic , Asian ( Indian and Korean ) adults between 20 and 40 years of age to determine the incidence of inherent varus ( mechanical limb alignment of > 3 ° varus ) and the factors influencing it . METHODS Three hundred and eighty-eight lower limbs were evaluated using full length , st and ing hip-to-ankle radiographs in 198 healthy , asymptomatic , Asian ( Indian and Korean ) adults between 20 and 40 years of age to assess the  hip-knee-ankle ( HKA ) angle , medial proximal tibial angle ( MPTA ) , femoral bowing and femoral neck-shaft angle  to determine the incidence of inherent varus ( mechanical limb alignment of > 3 ° varus ) and the factors influencing it . RESULTS Overall , the mean HKA angle was 177.6 ° ±2.6 ° with 34.5 % of limbs in inherent varus ( mean HKA angle 174.9 ° ±1.8 ° ) . The incidence of inherent varus was significantly higher ( p=0.01 ) in males ( 40 % ) compared to females ( 28 % ) but similar among Indian ( 34 % ) and Korean subjects ( 35 % ) . The hip-knee-ankle ( HKA ) angle showed significant positive correlation ( r=0.82 , p<0.001 ) with only the medial proximal tibial angle ( MPTA ) . CONCLUSIONS Inherent varus alignment of the lower limb is fairly common among asymptomatic , Asian adults . These results raise several pertinent questions regarding the role of inherent varus in the aetiopathogenesis of knee osteoarthritis and in lower limb realignment procedures We present the peak outcome results of the Oxford medial unicompartmental arthroplasty through a minimally invasive surgical incision . This prospect i ve study included 78 Oxford medial unicompartmental knee replacements in 68 patients . At the 2 year review the patients achieved a mean Oxford Knee Score of 38.3 . This was not significantly different to the 2 year results of the phase 2 Oxford knee carried out using a st and ard parapatellar approach when patients achieved a mean OKS of 36.0 . Four unicompartmental knee replacements required revision for unexplained pain , deep infection , aseptic loosening and bearing dislocation .  Minimally invasive joint replacement is attractive to both patients and surgeons , but is technically dem and ing with complications inherent to limited access Aims Approved by the Food and Drug Administration in 2004 , the Phase III Oxford Medial Partial Knee is used to treat anteromedial osteoarthritis ( AMOA ) in patients with an intact anterior cruciate ligament . This unicompartmental knee arthroplasty ( UKA ) is relatively new in the United States , and therefore long-term American results are lacking . Patients and Methods This is a single surgeon , retrospective study based on prospect ively collected data , analysing a consecutive series of primary UKAs using the  Phase III mobile-bearing Oxford Knee and Phase III instrumentation . Between July 2004 and December 2006 , the senior author ( RHE ) carried out a  medial UKA in 173 patients ( 213 knees ) for anteromedial osteoarthritis or avascular necrosis ( AVN ) . A total of 95 patients were men and 78 were women . Their mean age at surgery was 67 years ( 38 to 89 ) and mean body mass index 29.87 kg/m2 ( 17 to 62 ) . The mean follow-up was ten years ( 4 to 11 ) . Results Survivorship of the Oxford UKA at ten years was 88 % , using life table analysis . Implant survivorship at ten years was 95 % . The most common cause for revision was the progression of osteoarthritis in the lateral compartment . The mean knee score element of the American Knee Society Score ( AKSS ) was 50 pre-operatively and increased to 93 post-operatively . The mean AKSS function score was 56 pre-operatively rising to 78 post-operatively Conclusion This ten-year follow-up study of the Oxford UKA undertaken in the United States shows good survivorship and excellent function in a wide selection of patients with AMOA and AVN . Cite this article : Bone Joint J 2016;98-B(10 Suppl B):34–40 Aims The interest in unicompartmental knee arthroplasty ( UKA ) for medial osteoarthritis has increased rapidly but the long-term follow-up of the Oxford UKAs has yet to be analysed in non- design er centres . We have examined our ten- to 15-year clinical and radiological follow-up data for the Oxford Phase III UKAs . Patients and Methods Between January 1999 and January 2005 a total of 138 consecutive Oxford Phase III arthroplasties were performed by a single surgeon in 129 patients for medial compartment osteoarthritis ( 71 right and 67 left knees , mean age 72.0 years ( 47 to 91 ) , mean body mass index 28.2 ( 20.7 to 52.2 ) ) . Both clinical data and radiographs were prospect ively recorded and obtained at intervals . Of the 129 patients , 32 patients ( 32 knees ) died , ten patients ( 12 knees ) were not able to take part in the final clinical and radiological assessment due to physical and mental conditions , but via telephone interview it was confirmed that none of these ten patients ( 12 knees ) had a revision of the knee arthroplasty . One patient ( two knees ) was lost to follow-up . Results The mean follow-up was 11.7 years ( 10 to 15 ) . A total of 11 knees ( 8 % ) were revised . The survival at 15 years with revision for any reason as the endpoint was 90.6 % ( 95 % confidence interval ( CI ) 85.2 to 96.0 ) and revision related to the prosthesis was 99.3 % ( 95 % CI 97.9 to 100 ) . The mean total Knee Society Score was 47 ( 0 to 80 ) pre-operatively and 81 ( 30 to 100 ) at latest follow-up . The mean Oxford Knee Score was 19 ( 12 to 40 ) pre-operatively and 42 ( 28 to 55 ) at final follow-up . Radiolucency beneath the tibial component occurred in 22 of 81 prostheses ( 27.2 % ) without evidence of loosening . Conclusion This study supports the use of UKA in medial compartment osteoarthritis with excellent long-term functional and radiological outcomes with an excellent 15-year survival rate . Cite this article : Bone Joint J 2016;98-B(10 Suppl B):41–7 The purpose of this study was to evaluate the mid‐term results of an Oxford phase‐3 unicompartmental knee arthroplasty ( UKA ) for medial arthritis in Chinese patients There are several surgical management options for medial knee arthritis , and it is often difficult to decide whether a unicompartmental knee arthroplasty ( UKA ) or total knee arthroplasty ( TKA ) is appropriate . Few studies have compared UKAs and TKAs in the same patient . We identified 23 patients with osteoarthritis who had a TKA on one side and a UKA on the other . The preoperative values of the 2 knees were not statistically different . Strict criteria were used to determine whether a UKA could be performed ( functional anterior cruciate ligament , minimal deformity , and minimum changes in other compartments ) . Preoperative radiographs were review ed to confirm that the knee undergoing TKA had medial compartment disease only . Knee Society scores , radiographic analysis , and patient preferences were recorded for all patients . Average follow-up was 46 months ( range , 7.2 - 148 months ) and 42 months ( range , 11.5 - 59.8 months ) for TKA and UKA , respectively . We found little or no difference in outcomes between the 2 procedures , except for an improved range of motion with the UKA compared with the TKA ( 123 degrees + /-9 degrees vs 119.8 degrees + /-7 degrees , respectively ) . Knee Society scores improved from 45.9 to 89.7 in UKA and from 42.4 to 90.3 in TKA . Of the 23 patients , 11 expressed no preference between either knee and 12 preferred the unicompartmental knee ; no patient preferred the total knee . With appropriate patient selection , UKAs are a successful option for patients with osteoarthritis There have been concerns about the long-term survival of unicompartmental knee arthroplasty ( UKA ) . This prospect i ve study reports the 15-year survival and ten-year functional outcome of a consecutive series of 1000 minimally invasive Phase 3 Oxford medial UKAs ( 818 patients , 393 men , 48 % , 425 women , 52 % , mean age 66 years ; 32 to 88 ) . These were implanted by two surgeons involved with the design of the prosthesis to treat anteromedial osteoarthritis and spontaneous osteonecrosis of the knee , which are recommended indications . Patients were prospect ively identified and followed up independently for a mean of 10.3 years ( 5.3 to 16.6 ) . At ten years , the mean Oxford Knee Score was 40 ( st and ard deviation ( sd ) 9 ; 2 to 48 ) : 79 % of knees ( 349 ) had an excellent or good outcome . There were 52 implant-related re-operations at a mean of 5.5 years ( 0.2 to 14.7 ) . The most common reasons for re-operation were arthritis in the lateral compartment ( 2.5 % , 25 knees ) , bearing dislocation ( 0.7 % , seven knees ) and unexplained pain ( 0.7 % , seven knees ) . When all implant-related re-operations were considered as failures , the ten-year rate of survival was 94 % ( 95 % confidence interval ( CI ) 92 to 96 ) and the 15-year survival rate 91 % ( CI 83 to 98 ) . When failure of the implant was the endpoint the 15-year survival was 99 % ( CI 96 to 100 ) . This is the only large series of minimally invasive UKAs with 15-year survival data . The results support the continued use of minimally invasive UKA for the recommended indications Medium-term survivorship of the Oxford phase 3 unicompartmental knee replacement ( UKR ) has not yet been established in an Asian population . We prospect ively evaluated the outcome of 400 phase 3 Oxford UKRs in 320 Korean patients with a mean age at the time of operation of 69 years ( 48 to 82 ) . The mean follow-up was 5.2 years ( 1 to 10 ) . Clinical and radiological assessment was carried out pre- and post-operatively . At five years , the mean Knee Society knee and functional scores had increased significantly from 56.2 ( 30 to 91 ) pre-operatively to 87.2 ( 59 to 98 ) ( p = 0.034 ) and from 59.2 ( 30 to 93 ) to 88.3 ( 50 to 100 ) ( p = 0.021 ) , respectively . The Oxford knee score increased from a mean of 25.8 ( 12 to 39 ) pre-operatively to 39.8 ( 25 to 58 ) at five years ( p = 0.038 ) . The ten-year survival rate was 94 % ( 95 % confidence interval 90.1 to 98.0 ) . A total of 14 UKRs ( 3.5 % ) required revision . The most common reason for revision was dislocation of the bearing in 12 ( 3 % ) . Conversion to a total knee replacement was required in two patients who developed osteoarthritis of the lateral compartment . This is the largest published series of UKR in Korean patients . It shows that the mid-term results after a minimally invasive Oxford phase 3 UKR can yield satisfactory clinical and functional results in this group of patients
target: Conclusions Although total reoperation rates did not differ in the two population s , reoperation for bearing dislocation was more likely to occur in Asian than in Western patients , whereas reoperation for lateral knee OA progression was more likely to occur in Western than in Asian patients after Oxford Phase III UKA .
background: Background Implant survivorship is reported to be lower and complications , particularly bearing dislocation , are reported to be more frequent in Asian than in Western patients with medial knee osteoarthritis ( OA ) undergoing Oxford ® Phase III unicompartmental knee arthroplasty ( UKA ) .
  To date , however , these complications have not been compared between these groups of patients .
  Questions / purpose s The purpose of this study was to perform a meta- analysis comparing the st and ardized incidence rates of ( 1 ) all-cause reoperation ; ( 2 ) reoperation related to bearing dislocation ; and ( 3 ) reoperation related to progression of lateral compartment arthritis in Asian and Western patients with medial knee OA who underwent Oxford Phase III UKA .