The influence of surgical factors on dislocation of the meniscal bearing after Oxford medial unicompartmental knee replacement: a case-control study

Bone Joint J. 2014 Jul;96-B(7):914-22. doi: 10.1302/0301-620X.96B7.33352.

Abstract

The aim of this study was to evaluate the risk factors for dislocation of the bearing after a mobile-bearing Oxford medial unicompartmental knee replacement (UKR) and to test the hypothesis that surgical factors, as measured from post-operative radiographs, are associated with its dislocation From a total of 480 UKRs performed between 2001 and 2012, in 391 patients with a mean age of 66.5 years (45 to 82) (316 female, 75 male), we identified 17 UKRs where bearing dislocation occurred. The post-operative radiological measurements of the 17 UKRs and 51 matched controls were analysed using conditional logistic regression analysis. The post-operative radiological measurements included post-operative change in limb alignment, the position of the femoral and tibial components, the resection depth of the proximal tibia, and the femoral component-posterior condyle classification. We concluded that a post-operative decrease in the posterior tibial slope relative to the pre-operative value was the only significant determinant of dislocation of the bearing after medial Oxford UKR (odds ratio 1.881; 95% confidence interval 1.272 to 2.779). A post-operative posterior tibial slope < 8.45° and a difference between the pre-operative and post-operative posterior tibial slope of > 2.19° may increase the risk of dislocation.

Keywords: Bearing dislocation; Risk factor; Unicompartmental knee arthroplasty.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee*
  • Case-Control Studies
  • Female
  • Humans
  • Knee Prosthesis*
  • Logistic Models
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / surgery
  • Prosthesis Design
  • Prosthesis Failure*
  • Risk Factors