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Clinical Paper Review: Oxford Partial Knee Patients Experience Near Normal Gait Pattern Compared to Total Knee Patients

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The recent study by Wiik et al1 found that Oxford Partial Knee patients experience closer to normal gait patterns while walking downhill, when compared to TKA patients.

Summary

The authors performed a gait analysis on three cohorts, with the treadmill set at a decline of 7°, as a means of mimicking the everyday task of walking downhill.

  • 19 Oxford PKR patients at a minimum of 1 year post-op
  • 14 Total Knee patients, at a minimum of 1 year post-op
    • Groups were matched demographically, and on high post-op Oxford Knee Scores (OKS)
  • A group of 19 healthy patients, used as the control group

Conclusion

The conclusion of this article was that Oxford Partial Knee patients experienced closer to normal gait patterns on a treadmill with a 7° decline, compared to the TKA patients. The authors further found that the Oxford Partial Knee patients walked 15% faster than the TKA group, which was largely due to significantly longer stride lengths and more normal weight acceptance in the Oxford knee group. (Weight acceptance is the first two phases of the gait cycle, and can be described as the transfer of body weight onto a leg that has just finished swinging forward).

How do patients benefit more from a Partial Knee Replacement than a Total Knee Replacement?

The study by Wiik et al builds on existing literature showing that PKA has also been found to:

  • Allow for faster recovery and shorter hospital stays than TKA2
  • Provide an improved range of motion2-4
  • Preserve more natural bone4
  • Provide better functionality4 and a more natural motion3 than TKA
  • Result in fewer, and less severe, complications, including less morbidity compared with TKAs5-7
  • Deliver a substantial cost savings over TKA8 (£1,761 per knee)

In the United States (US), the Oxford Partial Knee is intended for use in individuals with osteoarthritis or avascular necrosis limited to the medial compartment of the knee and is intended to be implanted with bone cement; it is not indicated for use in the lateral compartment or patients with ligament deficiency. Various countries outside of the US offer Oxford partial knees intended for lateral use and Oxford Partial Knees with Cementless application; these devices are not available for sale in the US. Please check your local product clearances.

References

  1. Wiik, Anatole V., et al. "Downhill walking gait pattern discriminates between types of knee arthroplasty: improved physiological knee functionality in UKA versus TKA." Knee Surgery, Sports Traumatology, Arthroscopy (2014): 1-8.
  2. Lombardi Jr, Adolph V., et al. "Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty?." Clinical Orthopaedics and Related Research® 467.6 (2009): 1450-1457.
  3. Amin, Anish K., et al. "Unicompartmental or total knee arthroplasty?: Results from a matched study." Clinical orthopaedics and related research 451 (2006): 101-106.
  4. Deshmukh, Rahul V., and Richard D. Scott. "Unicompartmental knee arthroplasty: long-term results." Clinical orthopaedics and related research 392 (2001): 272-278.
  5. Brown, Nicholas M., et al. "Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis." The Journal of arthroplasty 27.8 (2012): 86-90.
  6. Robertsson, Otto, et al. "Use of unicompartmental instead of tricompart-mental prostheses for unicompartmental arthrosis in the knee is a cost-effective alternative: 15,437 primary tricompartmental prostheses were compared with 10,624 primary medial or lateral unicompartmental prostheses." Acta Orthopaedica 70.2 (1999): 170-175.
  7. Belfast Satisfaction Score: Orthopaedic Outcomes Units, Musgrave Park Hospital, Belfast
  8. Willis-Owen, Charles A., et al. "Unicondylar knee arthroplasty in the UK National Health Service: an analysis of candidacy, outcome and cost efficacy." The Knee 16.6 (2009): 473-478.