Clinical and biomechanical outcomes following unicondylar knee arthroplasty with Preservation fixed and mobile bearing tibial components

    Research output: ThesisDoctoral Thesis

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    Abstract

    [Truncated abstract] Unicondylar knee arthroplasty (UKA) has re-emerged as a successful treatment option for isolated single compartment tibio-femoral joint osteoarthritis. However despite its increasing use, controversy still remains over fixed or mobile bearing tibial components, as there is a lack to prospective randomised studies reported in the literature. In addition, the theoretical advantages of the mobile bearing for knee kinematics, kinetics and clinical outcome have not been evaluated in vivo. The aim of this research study was to explore the clinical and biomechanical outcomes of the fixed and mobile bearing UKA. . . . When the results for the both studies were combined, utilising the Preservation and MG fixed bearing prostheses, there was a significant relationship between knee adduction moment, and a poor prognosis predicted from RSA. Those patients with translation or rotation of the tibial component in any direction above 1mm and 1.5 degrees respectively were considered to have a poor prognosis for long term fixation. Of the 28 patients, the 8 patients considered to have a poor prognosis, had increased knee adduction moments post-surgery (mean difference = 1.66Nm.kg-1, p = 0.007). There was no difference between the groups for knee flexion moment (mean difference 0.16Nm.kg-1, p = 0.844). Pre-surgery gait was unable to predict the post-surgery outcome, due to the significant changes in gait from pre- to post-surgery. Care must taken when implanting the Preservation mobile bearing prosthesis, as long term outcome is questionable. The mobile bearing prosthesis also produced the worst clinical outcome, however the theoretical advantages of the mobile bearing does not affect gait. Gait analysis is a useful tool to identify patient who are overloading their prosthesis, leading to potential early failure. Identification of these gait patterns can allow for early intervention to reduce joint load, and possible extend the longevity of the prosthesis.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2006

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