Artikel
Oxford unicompartmental knee arthroplasty (OUKA) in severe varus and absent ACL
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Autoren
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Sanjeev Gokhale
- Gokhale Hospital, Pune, India
| Veröffentlicht: | 23. Oktober 2023 |
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Gliederung
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Objectives: to study feasibility of OUKA in patients with absent ACL and severe varus. OUKA is not recommended in patients with absent ACL andsevere varus of more than 15 degrees of HKA (hip knee ankle) angle. Few studies are published for OUKA done in knees with bothabsent ACL and varusmore than 15 degrees.
Methods: A retrospective study. A total 511 OUKAs, 331 patients. Out of 331, 270 available for complete follow up. 58 patients (17%), 78 knees had 15% varus. 12 knees had more than 20 degrees varus. 18 patients (5.4%), 25 knees had absent ACL. 10 patients (3%), 15 knees had both severe varus and absent ACL. OUKA done in intraoperatively stable knees andlow demand patients.Followed from 1 to 9 years. Level of evidence EBM 4.
Results and conclusion: In the entire cohort, the average age was 67, BMI 28. Male to female ratio 39:61. Preop HKA 11.5. Post op HKA 5. Preop OKS 18, post op OKS 38. Preop Tegner 1.35, post op Tegner 3.08. preop VAS 6.92 and post op VAS 1.85. Average age of the sub-cohort 69 years, BMI 27, preop HKA 15.5 post op HKA was 7.7., preop OKS 19.3, post op OKS 39.6. Preop Tegner 1.3 post op Tegner 3, and preop VAS 6.7 and post op VAS 1.5. in the entire cohort ‘complications’ in 13 out of 331 patients (3.9%), 13 knees in 511 OUKAs (2.54%) including 10 dislocations (1.9%), 2 fractures (0.39%) and 1 lat. Comp. OA (0.14%). Out of these 13 patients, there were 4 (30%) patients, 6 knees with severe varus. Out of 58 patients and 78 knees with severe varus, 3 patients (5.1%). 3 knees in 78 OUKAs (3.8%), had complications. Knees with no ACL had no complications. No complications in patients with severe varus and no ACL.
3 patients (5.1%) with severe varus had a complications (as compared to 3.9% in entire cohort) and 3.8% of knees with varus had complications (as compared to 2.54% in entire cohort). Unlike in TKR, OUKA are left with extra articular varus of 5 to 7 degrees.
Oxford replacement is useful in elderly low demand patients with absent ACL and severe varus meeting the preop criteria. The higher complication rate should be discussed with patients with severe varus preoperatively.
There was no conflict of interest.
