Our Summary

This research paper is about a study that examined two designs for a specific type of knee replacement surgery, the Oxford lateral Unicompartmental Knee Replacement (UKR). This surgery is often used to treat osteoarthritis in the knee. One issue with the surgery is that the bearing (a key part of the implant) can sometimes dislocate.

To try and reduce this problem, the researchers looked at a change in the design of the knee implant: from a flat surface to a domed one. They searched a variety of databases and resources to find relevant studies to compare the two designs.

The review found that changing the design from flat to domed significantly reduced the rate of bearing dislocation from 17% to 3.7%. This change also improved the long-term survival rate of the implant (meaning it lasted longer without needing to be replaced) to 93%.

That said, the researchers warn that the dislocation rate is still relatively high, suggesting that doctors should assess the stability of the bearing during surgery, and consider using a fixed bearing if needed. In other words, while the domed design is an improvement, there is still room for further advancements in this type of knee surgery.

FAQs

  1. What is the Oxford lateral Unicompartmental Knee Replacement (UKR) surgery used to treat?
  2. How does the domed design of the knee implant differ from the flat design in terms of dislocation rate and long-term survival?
  3. What are the researchers’ suggestions for further improvements in the Oxford lateral Unicompartmental Knee Replacement (UKR) surgery?

Doctor’s Tip

A helpful tip a doctor might give to a patient undergoing knee replacement surgery is to follow their post-operative rehabilitation plan diligently. This may include physical therapy exercises, proper wound care, and avoiding high-impact activities that could put stress on the new knee joint. By following the rehabilitation plan, patients can help ensure a successful recovery and long-term success of their knee replacement.

Suitable For

Patients who are typically recommended for knee replacement surgery, including the Oxford lateral Unicompartmental Knee Replacement, are those who have severe knee pain and stiffness that limits their daily activities, have not experienced relief from other conservative treatments such as medication or physical therapy, and have advanced osteoarthritis or other degenerative conditions in the knee joint. Additionally, patients who have a unicomparmental knee arthritis, meaning the arthritis is limited to one side of the knee joint, may be good candidates for a UKR surgery.

It is important for patients to consult with their orthopedic surgeon to determine if knee replacement surgery is the best option for their individual case. The decision to undergo knee replacement surgery should be made after careful consideration of the benefits and risks, as well as a thorough evaluation of the patient’s overall health and lifestyle.

Timeline

  • Before knee replacement surgery: Patients typically experience chronic knee pain, stiffness, swelling, and limited mobility due to osteoarthritis or other conditions affecting the knee joint. They may have tried other conservative treatments such as physical therapy, medications, injections, and assistive devices with limited success.

  • Consultation and preparation: Patients consult with an orthopedic surgeon who evaluates their condition, discusses treatment options, and recommends knee replacement surgery if deemed necessary. Pre-operative tests and evaluations are conducted to ensure the patient is a good candidate for surgery.

  • Knee replacement surgery: The patient undergoes knee replacement surgery, where the damaged parts of the knee joint are removed and replaced with an artificial implant. The surgery can be partial (UKR) or total (TKR) depending on the extent of damage in the knee joint.

  • Recovery and rehabilitation: After surgery, patients undergo a period of recovery and rehabilitation, which includes pain management, physical therapy, and gradual increase in activity levels. The goal is to improve strength, flexibility, and mobility in the knee joint.

  • Follow-up appointments: Patients have regular follow-up appointments with their surgeon to monitor their progress, address any concerns or complications, and assess the long-term success of the knee replacement surgery.

  • Post-surgery outcomes: Patients who undergo knee replacement surgery experience reduced pain, improved mobility, and better quality of life. The success of the surgery depends on various factors such as patient compliance with post-operative care, overall health, and the type of implant used.

Overall, knee replacement surgery can significantly improve the quality of life for patients with chronic knee pain and mobility issues. Advanced designs and techniques continue to evolve to enhance the outcomes and longevity of knee implants.

What to Ask Your Doctor

Some questions a patient should ask their doctor about knee replacement surgery include:

  1. What type of knee replacement surgery are you recommending for me?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery process, and what can I expect in terms of pain and mobility during this time?
  4. Will I need physical therapy after the surgery, and if so, for how long?
  5. What is the success rate of this specific type of knee replacement surgery?
  6. Are there any alternative treatments or procedures that I should consider before opting for surgery?
  7. How long can I expect the knee implant to last before needing to be replaced?
  8. What steps will be taken during surgery to minimize the risk of complications, such as bearing dislocation?
  9. What is your experience and success rate with performing this type of knee replacement surgery?
  10. Are there any lifestyle changes or precautions I should take after the surgery to ensure the longevity of the implant?

By asking these questions, patients can better understand the procedure, potential outcomes, and necessary steps for a successful knee replacement surgery.

Reference

Authors: Yang I, Hamilton TW, Mellon SJ, Murray DW. Journal: Knee. 2021 Jan;28:214-228. doi: 10.1016/j.knee.2020.10.013. Epub 2021 Jan 7. PMID: 33422937