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Valgus subsidence of the tibial component in cementless Oxford unicompartmental knee replacement.

Liddle AD, Pandit HG, Jenkins C, Lobenhoffer P, Jackson WF, Dodd CA, Murray DW - Bone Joint J (2014)

Bottom Line: The cementless Oxford unicompartmental knee replacement has been demonstrated to have superior fixation on radiographs and a similar early complication rate compared with the cemented version.However, a small number of cases have come to our attention where, after an apparently successful procedure, the tibial component subsides into a valgus position with an increased posterior slope, before becoming well-fixed.This situation appears to be avoidable by minor modifications to the operative technique, and it appears that it can be treated conservatively in most patients.

View Article: PubMed Central - PubMed

Affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Road, OX3 7LD, UK.

ABSTRACT
The cementless Oxford unicompartmental knee replacement has been demonstrated to have superior fixation on radiographs and a similar early complication rate compared with the cemented version. However, a small number of cases have come to our attention where, after an apparently successful procedure, the tibial component subsides into a valgus position with an increased posterior slope, before becoming well-fixed. We present the clinical and radiological findings of these six patients and describe their natural history and the likely causes. Two underwent revision in the early post-operative period, and in four the implant stabilised and became well-fixed radiologically with a good functional outcome. This situation appears to be avoidable by minor modifications to the operative technique, and it appears that it can be treated conservatively in most patients.

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Related in: MedlinePlus

Radiographs showinga) anteroposterior view of patient 1 immediately post-operatively,b), following subsidence and c), five years post-operatively. Radiographd) shows lateral view of patient 1 immediately post-operatively;e), following subsidence, and f) five years post-operatively.
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f1: Radiographs showinga) anteroposterior view of patient 1 immediately post-operatively,b), following subsidence and c), five years post-operatively. Radiographd) shows lateral view of patient 1 immediately post-operatively;e), following subsidence, and f) five years post-operatively.


Valgus subsidence of the tibial component in cementless Oxford unicompartmental knee replacement.

Liddle AD, Pandit HG, Jenkins C, Lobenhoffer P, Jackson WF, Dodd CA, Murray DW - Bone Joint J (2014)

Radiographs showinga) anteroposterior view of patient 1 immediately post-operatively,b), following subsidence and c), five years post-operatively. Radiographd) shows lateral view of patient 1 immediately post-operatively;e), following subsidence, and f) five years post-operatively.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4292015&req=5

f1: Radiographs showinga) anteroposterior view of patient 1 immediately post-operatively,b), following subsidence and c), five years post-operatively. Radiographd) shows lateral view of patient 1 immediately post-operatively;e), following subsidence, and f) five years post-operatively.
Bottom Line: The cementless Oxford unicompartmental knee replacement has been demonstrated to have superior fixation on radiographs and a similar early complication rate compared with the cemented version.However, a small number of cases have come to our attention where, after an apparently successful procedure, the tibial component subsides into a valgus position with an increased posterior slope, before becoming well-fixed.This situation appears to be avoidable by minor modifications to the operative technique, and it appears that it can be treated conservatively in most patients.

View Article: PubMed Central - PubMed

Affiliation: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Windmill Road, OX3 7LD, UK.

ABSTRACT
The cementless Oxford unicompartmental knee replacement has been demonstrated to have superior fixation on radiographs and a similar early complication rate compared with the cemented version. However, a small number of cases have come to our attention where, after an apparently successful procedure, the tibial component subsides into a valgus position with an increased posterior slope, before becoming well-fixed. We present the clinical and radiological findings of these six patients and describe their natural history and the likely causes. Two underwent revision in the early post-operative period, and in four the implant stabilised and became well-fixed radiologically with a good functional outcome. This situation appears to be avoidable by minor modifications to the operative technique, and it appears that it can be treated conservatively in most patients.

Show MeSH
Related in: MedlinePlus