Skip to main content
SpringerLink
Log in

Accelerated rehabilitation following Oxford unicompartmental knee arthroplasty: five-year results from an independent centre

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

The purpose of this study was to analyse the midterm outcomes of an accelerated rehabilitation programme for unicompartmental knee arthroplasty. One hundred and six patients (187 knees) underwent a minimally invasive Phase 3 Oxford unicompartmental knee arthroplasty with an accelerated rehabilitation programme and were followed over the first 5 years. The emphasis of the programme was pre-operative patient education, multidisciplinary discharge planning and early rehabilitation. On retrospective analysis, patients reported a significant improvement in functional outcomes and quality of life in respect of Oxford knee score, American knee score and short form-12 outcomes (P < 0.05). These improved clinical outcomes were then maintained during the 5-year period. The results support the use of accelerated rehabilitation to optimise early hospital discharge without jeopardising early and midterm outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomised controlled trial. J Bone Joint Surg Br 91B:52–57

    Google Scholar 

  2. Emerson RH Jr, Higgins LL (2008) Unicompartmental knee arthroplasty with the oxford prosthesis in patients with medial compartment arthritis. J Bone Joint Surg 90A:118–122

    Article  Google Scholar 

  3. Bruni D, Iacono F, Russo A, Zaffagnini S, Muccioli GM, Bignozzi S, Bragonzoni L, Marcacci M (2009) Minimally invasive unicompartmental knee replacement: retrospective clinical and radiographic evaluation of 83 patients. Knee Surg Sports Traumatol Arthrosc: In Press

  4. Argenson J, Benkeddache Y, Aubaniac J (2002) Modern unicompartmental knee arthroplasty with cement. A three to ten-year follow-up study. J Bone Joint Surg Am 84A:2235–2239

    Google Scholar 

  5. Rees JL, Price AJ, Beard DJ, Dodd CAF, Murray DW (2004) Minimally invasive Oxford unicompartmental knee arthroplasty: functional results at 1 year and the effect of surgical inexperience. Knee 11:363–367

    Article  PubMed  CAS  Google Scholar 

  6. Kort NP, van Raay JJ, Cheung J, Jolink C, Deutman R (2007) Analysis of Oxford medial unicompartmental knee replacement using the minimally invasive technique in patients aged 60 and above: an independent prospective series. Knee Surg Sports Traumatol Arthrosc 15:1331–1334

    Article  PubMed  Google Scholar 

  7. Murray DW, Goodfellow JW, O’Connor JJ (1998) The Oxford medial unicompartmental arthroplasty. J Bone Joint Surg Br 80B:983–989

    Article  Google Scholar 

  8. Jenkins C, Barker KL, Reilly KA, Pandit H, Dodd CAF, Murray DW (2006) Physiotherapy management of minimally invasive Oxford medial compartment knee arthroplasty: an observational study of 100 patients following an accelerated treatment protocol. Physiotherapy 92:214–218

    Article  Google Scholar 

  9. Beard DJ, Murray DW, Rees JL, Price AJ, Dodd CA (2002) Accelerated recovery for unicompartmental knee replacement–a feasibility study. Knee 9:221–224

    Article  PubMed  CAS  Google Scholar 

  10. Reilly KA, Beard DJ, Barker KL, Dodd CAF, Price AJ, Murray DW (2005) Efficacy of an accelerated recovery protocol for Oxford unicompartmental knee arthroplasty–randomised controlled trial. Knee 12:351–357

    Article  PubMed  CAS  Google Scholar 

  11. Borgwardt L, Zerahn B, Bliddal H, Christiansen C, Sylvest J, Borgwardt A (2009) Similar clinical outcome after unicompartmental knee arthroplasty using a conventional or accelerated care program: a randomized, controlled study of 40 patients. Acta Orthop 80:334–337

    Article  PubMed  Google Scholar 

  12. Larsen K, Sørensen OG, Hansen TB, Thomsen PB, Søballe K (2008) Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: a randomized clinical trial involving 87 patients with 3 months of follow-up. Acta Orthop 79:149–159

    Article  PubMed  Google Scholar 

  13. Dawson J, Fitzpatrick R, Murray D, Carr A (1998) Questionnaire on the perceptions of patients about total knee replacement surgery. J. Bone Joint Surg Br 80B:63–69

    Article  Google Scholar 

  14. Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of The Knee Society Clinical Rating System. Clin Orthop 248:13–14

    PubMed  Google Scholar 

  15. Ware JE, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233

    Article  PubMed  Google Scholar 

  16. Pandit H, Jenkins C, Barker K, Dodd CAF, Murray DW (2006) The Oxford medial unicompartmental knee replacement using a minimally-invasive approach. J Bone Joint Surg Br 88B:54–60

    Google Scholar 

  17. Song MH, Kim BH, Ahn SJ, Yoo SH, Lee MS (2009) Early complications after minimally invasive mobile-bearing medial unicompartmental knee arthroplasty. J Arthroplasty 24:1281–1284

    Article  PubMed  Google Scholar 

  18. Heller S, Fenichel I, Salai M, Luria T, Velkes S (2009) The Oxford unicompartmental knee prosthesis for the treatment of medial compartment knee disease: 2 to 5 year follow-up. Isr Med Assoc J 11:266–268

    PubMed  Google Scholar 

  19. Cool S, Victor J, De Baets T (2006) Does a minimally invasive approach affect positioning of components in unicompartmental knee arthroplasty? Early results with survivorship analysis. Acta Orthop Belg 72:709–715

    PubMed  Google Scholar 

  20. Lucas B (2008) Total hip and total knee replacement: preoperative nursing management. Br J Nurs 17:1346–1351

    PubMed  Google Scholar 

  21. Nuñez M, Nuñez E, Segur JM, Macule F, Quinto L, Hernandez MV, Vilalta C (2006) The effect of an educational program to improve health-related quality of life in patients with osteoarthritis on waiting list for total knee replacement: a randomized study. Osteoarthritis Cartilage 14:279–285

    Article  PubMed  Google Scholar 

  22. Merrill A, Ritter MD, Davis KE, Berend ME (2008) The effect of postoperative range of motion on functional activities after posterior cruciate-retaining total knee arthroplasty. J Bone Joint Surg Am 90A:777–784

    Google Scholar 

  23. Soohoo NF, Sharifi H, Kominski G, Lieberman JR (2006) Cost-effectiveness analysis of unicompartmental knee arthroplasty as an alternative to total knee arthroplasty for unicompartmental osteoarthritis. J Bone Joint Surg Am 88A:1975–1982

    Article  Google Scholar 

  24. Sigurdsson E, Siggeirsdottir K, Jonsson H Jr, Gudnason V, Matthiasson T, Jonsson BY (2008) Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study. Int J Health Care Finance Econ 8:181–192

    Article  PubMed  Google Scholar 

  25. NHS (2010) Institute of Innovation and Improvement. Accessed 07.07.2010. Available at: http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/length_of_stay.html

  26. Willis-Owen CA, Brust K, Alsop H, Miraldo M, Cobb JP (2009) Unicondylar knee arthroplasty in the UK National Health Service: an analysis of candidacy, outcome and cost efficacy. Knee 16:473–478

    Article  PubMed  Google Scholar 

  27. Lizaur A, Marco L, Cebrian R (1997) Preoperative factors influencing the range of movement after total knee arthroplasty for severe osteoarthritis. J Bone Joint Surg Br 79B:626–629

    Article  Google Scholar 

  28. Berend KR, Lombardi AV Jr, Adams JB (2007) Obesity, young age, patellofemoral disease, and anterior knee pain: identifying the unicondylar arthroplasty patient in the United States. Orthopedics 30(5):19–23

    PubMed  Google Scholar 

  29. Luepongsak N, Amin S, Krebs DE, McGibbon CA, Felson D (2002) The contribution of type of daily activity to loading across the hip and knee joints in the elderly. Osteoarthritis Cartilage 10:353–359

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

Funds have been received by the department from Biomet to support the salaries of the Research Physiotherapists involved in this study. The Research Physiotherapist involved in this study and publication was funded by Biomet, the manufacturer of the Oxford Unicompartmental Knee Arthroplasty.

Conflict of interest

None.

Ethical standard

Since the data collected were analysed retrospectively as part of an ongoing hospital survey, and patients attended their routine clinic appointments, ethical approval was not required.

Author information

Authors and Affiliations

  1. Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, NR4 7UY, UK

    Toby O. Smith, Rachel Chester & Simon T. Donell

  2. Department of Orthopaedics and Trauma, Norfolk and Norwich University NHS Hospital Foundation Trust, Norwich, Norfolk, UK

    Malcolm M. Glasgow & Simon T. Donell

Authors
  1. Toby O. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rachel Chester
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Malcolm M. Glasgow
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Simon T. Donell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toby O. Smith.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, T.O., Chester, R., Glasgow, M.M. et al. Accelerated rehabilitation following Oxford unicompartmental knee arthroplasty: five-year results from an independent centre. Eur J Orthop Surg Traumatol 22, 151–158 (2012). https://doi.org/10.1007/s00590-011-0797-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-011-0797-7

Keywords

Search

Navigation