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 |
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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 |
format | Article |
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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.</description><identifier>ISSN: 2049-4394</identifier><identifier>EISSN: 2049-4408</identifier><identifier>DOI: 10.1302/0301-620X.98B10.BJJ-2016-0483.R1</identifier><identifier>PMID: 27694512</identifier><language>eng</language><publisher>England: British Editorial Society of Bone and Joint Surgery</publisher><subject>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</subject><ispartof>The bone & joint journal, 2016-10, Vol.98-B (10 Supple B), p.22-27</ispartof><rights>2016 Price et al.</rights><rights>2016 Price et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c323t-4de103f797b4ec2c279e46529c9dde9de95ef1e0a0fc92168ec5a9621d842cab3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27694512$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><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><title>A survival analysis of 1084 knees of the Oxford unicompartmental knee arthroplasty: a comparison between consultant and trainee surgeons</title><title>The bone & joint journal</title><addtitle>Bone Joint J</addtitle><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.</description><subject>Aged</subject><subject>Arthroplasty</subject><subject>Arthroplasty, Replacement, Knee - education</subject><subject>Arthroplasty, Replacement, Knee - instrumentation</subject><subject>Arthroplasty, Replacement, Knee - methods</subject><subject>Arthroplasty, Replacement, Knee - standards</subject><subject>Clinical Competence</subject><subject>Consultants</subject><subject>Education, Medical, Graduate</subject><subject>England</subject><subject>Female</subject><subject>Humans</subject><subject>Knee</subject><subject>Knee Prosthesis</subject><subject>Life Tables</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Osteoarthritis, Knee - surgery</subject><subject>Partial</subject><subject>Prosthesis Design</subject><subject>Prosthesis Failure</subject><subject>Reoperation - methods</subject><subject>Reoperation - statistics & numerical data</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Tertiary Care Centers - standards</subject><subject>Tertiary Care Centers - statistics & numerical data</subject><subject>Trainee</subject><subject>Treatment Outcome</subject><issn>2049-4394</issn><issn>2049-4408</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkdtu3CAQhlHVqIm2eYWKy9x4ywA-0IuqSZQeokiRolTqHWLxOOvWhi3gbfcN-tjF2SRKEBLMzD__gD5CToAtQTD-ngkGRcXZj6VqznLy7PKy4AyqgslGLG_gFTniTKpCSta8frwLJQ_JcYw_WV4NA5DwhhzyulKyBH5E_p3SOIVtvzUDNc4Mu9hH6jsKrJH0l0O8j9Ia6fXfzoeWTq63ftyYkEZ0KXfNIprDdfCbwcS0-0AN3Uv66B1dYfqD6HLKxWlIxqU8qKUpmH7uzNPvMJfekoPODBGPH84F-f754vb8a3F1_eXb-elVYQUXqZAtAhNdreqVRMstrxXKquTKqrZFlXeJHSAzrLOKQ9WgLY2qOLSN5NasxIJ83PtuptWIrc2fCGbQm9CPJuy0N71-WXH9Wt_5rS6ZrCG_YUFOHgyC_z1hTHrso8VhMA79FDU0ohRlVtZZ-mkvtcHHGLB7GgNMz0z1zFTPTPU9U52Z6pmpnpnqG8gW754_98ngkaD4D6_Bos0</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Bottomley, N</creator><creator>Jones, L D</creator><creator>Rout, R</creator><creator>Alvand, A</creator><creator>Rombach, I</creator><creator>Evans, T</creator><creator>Jackson, W F M</creator><creator>Beard, D J</creator><creator>Price, A J</creator><general>British Editorial Society of Bone and Joint Surgery</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20161001</creationdate><title>A survival analysis of 1084 knees of the Oxford unicompartmental knee arthroplasty: a comparison between consultant and trainee surgeons</title><author>Bottomley, N ; Jones, L D ; Rout, R ; Alvand, A ; Rombach, I ; Evans, T ; Jackson, W F M ; Beard, D J ; Price, A J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c323t-4de103f797b4ec2c279e46529c9dde9de95ef1e0a0fc92168ec5a9621d842cab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Arthroplasty</topic><topic>Arthroplasty, Replacement, Knee - education</topic><topic>Arthroplasty, Replacement, Knee - instrumentation</topic><topic>Arthroplasty, Replacement, Knee - methods</topic><topic>Arthroplasty, Replacement, Knee - standards</topic><topic>Clinical Competence</topic><topic>Consultants</topic><topic>Education, Medical, Graduate</topic><topic>England</topic><topic>Female</topic><topic>Humans</topic><topic>Knee</topic><topic>Knee Prosthesis</topic><topic>Life Tables</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Osteoarthritis, Knee - surgery</topic><topic>Partial</topic><topic>Prosthesis Design</topic><topic>Prosthesis Failure</topic><topic>Reoperation - methods</topic><topic>Reoperation - statistics & numerical data</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Tertiary Care Centers - standards</topic><topic>Tertiary Care Centers - statistics & 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 & joint journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bottomley, N</au><au>Jones, L D</au><au>Rout, R</au><au>Alvand, A</au><au>Rombach, I</au><au>Evans, T</au><au>Jackson, W F M</au><au>Beard, D J</au><au>Price, A J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A survival analysis of 1084 knees of the Oxford unicompartmental knee arthroplasty: a comparison between consultant and trainee surgeons</atitle><jtitle>The bone & joint journal</jtitle><addtitle>Bone Joint J</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>98-B</volume><issue>10 Supple B</issue><spage>22</spage><epage>27</epage><pages>22-27</pages><issn>2049-4394</issn><eissn>2049-4408</eissn><abstract>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.</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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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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