A survival analysis of 1084 knees of the Oxford unicompartmental knee arthroplasty: a comparison between consultant and trainee surgeons

The aim of this to study was to compare the previously unreported long-term survival outcome of the Oxford medial unicompartmental knee arthroplasty (UKA) performed by trainee surgeons and consultants. We therefore identified a previously unreported cohort of 1084 knees in 947 patients who had a UKA...

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Veröffentlicht in:The bone & joint journal 2016-10, Vol.98-B (10 Supple B), p.22-27
Hauptverfasser: Bottomley, N, Jones, L D, Rout, R, Alvand, A, Rombach, I, Evans, T, Jackson, W F M, Beard, D J, Price, A J
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container_end_page 27
container_issue 10 Supple B
container_start_page 22
container_title The bone & joint journal
container_volume 98-B
creator Bottomley, N
Jones, L D
Rout, R
Alvand, A
Rombach, I
Evans, T
Jackson, W F M
Beard, D J
Price, A J
description The aim of this to study was to compare the previously unreported long-term survival outcome of the Oxford medial unicompartmental knee arthroplasty (UKA) performed by trainee surgeons and consultants. We therefore identified a previously unreported cohort of 1084 knees in 947 patients who had a UKA inserted for anteromedial knee arthritis by consultants and surgeons in training, at a tertiary arthroplasty centre and performed survival analysis on the group with revision as the endpoint. The ten-year cumulative survival rate for revision or exchange of any part of the prosthetic components was 93.2% (95% confidence interval (CI) 86.1 to 100, number at risk 45). Consultant surgeons had a nine-year cumulative survival rate of 93.9% (95% CI 90.2 to 97.6, number at risk 16). Trainee surgeons had a cumulative nine-year survival rate of 93.0% (95% CI 90.3 to 95.7, number at risk 35). Although there was no differences in implant survival between consultants and trainees (p = 0.30), there was a difference in failure pattern whereby all re-operations performed for bearing dislocation (n = 7), occurred in the trainee group. This accounted for 0.6% of the entire cohort and 15% of the re-operations. This is the largest single series of the Oxford UKA ever reported and demonstrates that good results can be achieved by a heterogeneous group of surgeons, including trainees, if performed within a high-volume centre with considerable experience with the procedure. Cite this article: Bone Joint J 2016;(10 Suppl B):22-7.
doi_str_mv 10.1302/0301-620X.98B10.BJJ-2016-0483.R1
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We therefore identified a previously unreported cohort of 1084 knees in 947 patients who had a UKA inserted for anteromedial knee arthritis by consultants and surgeons in training, at a tertiary arthroplasty centre and performed survival analysis on the group with revision as the endpoint. The ten-year cumulative survival rate for revision or exchange of any part of the prosthetic components was 93.2% (95% confidence interval (CI) 86.1 to 100, number at risk 45). Consultant surgeons had a nine-year cumulative survival rate of 93.9% (95% CI 90.2 to 97.6, number at risk 16). Trainee surgeons had a cumulative nine-year survival rate of 93.0% (95% CI 90.3 to 95.7, number at risk 35). Although there was no differences in implant survival between consultants and trainees (p = 0.30), there was a difference in failure pattern whereby all re-operations performed for bearing dislocation (n = 7), occurred in the trainee group. This accounted for 0.6% of the entire cohort and 15% of the re-operations. This is the largest single series of the Oxford UKA ever reported and demonstrates that good results can be achieved by a heterogeneous group of surgeons, including trainees, if performed within a high-volume centre with considerable experience with the procedure. 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We therefore identified a previously unreported cohort of 1084 knees in 947 patients who had a UKA inserted for anteromedial knee arthritis by consultants and surgeons in training, at a tertiary arthroplasty centre and performed survival analysis on the group with revision as the endpoint. The ten-year cumulative survival rate for revision or exchange of any part of the prosthetic components was 93.2% (95% confidence interval (CI) 86.1 to 100, number at risk 45). Consultant surgeons had a nine-year cumulative survival rate of 93.9% (95% CI 90.2 to 97.6, number at risk 16). Trainee surgeons had a cumulative nine-year survival rate of 93.0% (95% CI 90.3 to 95.7, number at risk 35). Although there was no differences in implant survival between consultants and trainees (p = 0.30), there was a difference in failure pattern whereby all re-operations performed for bearing dislocation (n = 7), occurred in the trainee group. This accounted for 0.6% of the entire cohort and 15% of the re-operations. This is the largest single series of the Oxford UKA ever reported and demonstrates that good results can be achieved by a heterogeneous group of surgeons, including trainees, if performed within a high-volume centre with considerable experience with the procedure. 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numerical data</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Tertiary Care Centers - standards</topic><topic>Tertiary Care Centers - statistics &amp; numerical data</topic><topic>Trainee</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bottomley, N</creatorcontrib><creatorcontrib>Jones, L D</creatorcontrib><creatorcontrib>Rout, R</creatorcontrib><creatorcontrib>Alvand, A</creatorcontrib><creatorcontrib>Rombach, I</creatorcontrib><creatorcontrib>Evans, T</creatorcontrib><creatorcontrib>Jackson, W F M</creatorcontrib><creatorcontrib>Beard, D J</creatorcontrib><creatorcontrib>Price, A J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The bone &amp; 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We therefore identified a previously unreported cohort of 1084 knees in 947 patients who had a UKA inserted for anteromedial knee arthritis by consultants and surgeons in training, at a tertiary arthroplasty centre and performed survival analysis on the group with revision as the endpoint. The ten-year cumulative survival rate for revision or exchange of any part of the prosthetic components was 93.2% (95% confidence interval (CI) 86.1 to 100, number at risk 45). Consultant surgeons had a nine-year cumulative survival rate of 93.9% (95% CI 90.2 to 97.6, number at risk 16). Trainee surgeons had a cumulative nine-year survival rate of 93.0% (95% CI 90.3 to 95.7, number at risk 35). Although there was no differences in implant survival between consultants and trainees (p = 0.30), there was a difference in failure pattern whereby all re-operations performed for bearing dislocation (n = 7), occurred in the trainee group. This accounted for 0.6% of the entire cohort and 15% of the re-operations. This is the largest single series of the Oxford UKA ever reported and demonstrates that good results can be achieved by a heterogeneous group of surgeons, including trainees, if performed within a high-volume centre with considerable experience with the procedure. Cite this article: Bone Joint J 2016;(10 Suppl B):22-7.</abstract><cop>England</cop><pub>British Editorial Society of Bone and Joint Surgery</pub><pmid>27694512</pmid><doi>10.1302/0301-620X.98B10.BJJ-2016-0483.R1</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Journals@Ovid Complete; Alma/SFX Local Collection
subjects Aged
Arthroplasty
Arthroplasty, Replacement, Knee - education
Arthroplasty, Replacement, Knee - instrumentation
Arthroplasty, Replacement, Knee - methods
Arthroplasty, Replacement, Knee - standards
Clinical Competence
Consultants
Education, Medical, Graduate
England
Female
Humans
Knee
Knee Prosthesis
Life Tables
Male
Middle Aged
Osteoarthritis, Knee - surgery
Partial
Prosthesis Design
Prosthesis Failure
Reoperation - methods
Reoperation - statistics & numerical data
Survival
Survival Analysis
Tertiary Care Centers - standards
Tertiary Care Centers - statistics & numerical data
Trainee
Treatment Outcome
title A survival analysis of 1084 knees of the Oxford unicompartmental knee arthroplasty: a comparison between consultant and trainee surgeons
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