A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man
<p><strong>Background and purpose</strong> — Registries report high revision rates after unicompartmental knee replacement (UKR) due, in part, to aseptic loosing. In an attempt to improve Oxford UKR femoral component fixation a new design was introduced with a Twin rather than a Si...
| Main Authors: | , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Taylor and Francis
2020
|
| _version_ | 1826270625080016896 |
|---|---|
| author | Mohammad, HR Matharu, GS Judge, A Murray, DW |
| author_facet | Mohammad, HR Matharu, GS Judge, A Murray, DW |
| author_sort | Mohammad, HR |
| collection | OXFORD |
| description | <p><strong>Background and purpose</strong> — Registries report high revision rates after unicompartmental knee replacement (UKR) due, in part, to aseptic loosing. In an attempt to improve Oxford UKR femoral component fixation a new design was introduced with a Twin rather than a Single peg. We used the National Joint Registry (NJR) to compare the 5-year outcomes of the Single and Twin Peg cemented Oxford UKRs.</p>
<p><strong>Patients and methods</strong> — We performed a retrospective observational study using NJR data on propensity score matched Single and Twin Peg UKRs (matched for patient, implant and surgical factors). Data on 2,834 Single Peg and 2,834 Twin Peg were analyzed. Cumulative implant survival was calculated using the Kaplan–Meier method and comparisons between groups performed using Cox regression models.</p>
<p><strong>Results</strong> — In the matched cohort, the mean follow up for both Single and Twin Peg UKRs was 3.3 (SD 2) and 3.4 years (SD 2) respectively. The 5-year cumulative implant survival rates for Single Peg and Twin Peg were 94.8% (95% CI 93.6–95.8) and 96.2% (CI 95.1–97.1) respectively. Implant revision rates were statistically significantly lower in the Twin Peg (hazard ratio [HR)] = 0.74; p = 0.04). The revision rate for femoral component aseptic loosening decreased significantly (p = 0.03) from 0.4% (n = 11) with the Single Peg to 0.1% (n = 3) with the Twin Peg. The revision rate for pain decreased significantly (p = 0.01) from 0.8% (n = 23) with the Single Peg to 0.3% (n = 9) with the Twin Peg. No other reasons for revision had significant differences in revision rates.</p>
<p><strong>Interpretation</strong> — The revision rate for the cemented Twin Peg Oxford UKR was 26% less than the Single Peg Oxford UKR. This was mainly because the revision rates for femoral loosening and pain more than halved. This suggests that the Twin Peg component should be used in preference to the Single Peg design.</p> |
| first_indexed | 2024-03-06T21:43:47Z |
| format | Journal article |
| id | oxford-uuid:48d779f8-ed35-4b69-94a9-f066760a6c71 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T21:43:47Z |
| publishDate | 2020 |
| publisher | Taylor and Francis |
| record_format | dspace |
| spelling | oxford-uuid:48d779f8-ed35-4b69-94a9-f066760a6c712022-03-26T15:28:09ZA matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of ManJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:48d779f8-ed35-4b69-94a9-f066760a6c71EnglishSymplectic ElementsTaylor and Francis2020Mohammad, HRMatharu, GSJudge, AMurray, DW<p><strong>Background and purpose</strong> — Registries report high revision rates after unicompartmental knee replacement (UKR) due, in part, to aseptic loosing. In an attempt to improve Oxford UKR femoral component fixation a new design was introduced with a Twin rather than a Single peg. We used the National Joint Registry (NJR) to compare the 5-year outcomes of the Single and Twin Peg cemented Oxford UKRs.</p> <p><strong>Patients and methods</strong> — We performed a retrospective observational study using NJR data on propensity score matched Single and Twin Peg UKRs (matched for patient, implant and surgical factors). Data on 2,834 Single Peg and 2,834 Twin Peg were analyzed. Cumulative implant survival was calculated using the Kaplan–Meier method and comparisons between groups performed using Cox regression models.</p> <p><strong>Results</strong> — In the matched cohort, the mean follow up for both Single and Twin Peg UKRs was 3.3 (SD 2) and 3.4 years (SD 2) respectively. The 5-year cumulative implant survival rates for Single Peg and Twin Peg were 94.8% (95% CI 93.6–95.8) and 96.2% (CI 95.1–97.1) respectively. Implant revision rates were statistically significantly lower in the Twin Peg (hazard ratio [HR)] = 0.74; p = 0.04). The revision rate for femoral component aseptic loosening decreased significantly (p = 0.03) from 0.4% (n = 11) with the Single Peg to 0.1% (n = 3) with the Twin Peg. The revision rate for pain decreased significantly (p = 0.01) from 0.8% (n = 23) with the Single Peg to 0.3% (n = 9) with the Twin Peg. No other reasons for revision had significant differences in revision rates.</p> <p><strong>Interpretation</strong> — The revision rate for the cemented Twin Peg Oxford UKR was 26% less than the Single Peg Oxford UKR. This was mainly because the revision rates for femoral loosening and pain more than halved. This suggests that the Twin Peg component should be used in preference to the Single Peg design.</p> |
| spellingShingle | Mohammad, HR Matharu, GS Judge, A Murray, DW A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man |
| title | A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man |
| title_full | A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man |
| title_fullStr | A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man |
| title_full_unstemmed | A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man |
| title_short | A matched comparison of revision rates of cemented Oxford Unicompartmental Knee Replacements with Single and Twin Peg femoral components, based on data from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man |
| title_sort | matched comparison of revision rates of cemented oxford unicompartmental knee replacements with single and twin peg femoral components based on data from the national joint registry for england wales northern ireland and the isle of man |
| work_keys_str_mv | AT mohammadhr amatchedcomparisonofrevisionratesofcementedoxfordunicompartmentalkneereplacementswithsingleandtwinpegfemoralcomponentsbasedondatafromthenationaljointregistryforenglandwalesnorthernirelandandtheisleofman AT matharugs amatchedcomparisonofrevisionratesofcementedoxfordunicompartmentalkneereplacementswithsingleandtwinpegfemoralcomponentsbasedondatafromthenationaljointregistryforenglandwalesnorthernirelandandtheisleofman AT judgea amatchedcomparisonofrevisionratesofcementedoxfordunicompartmentalkneereplacementswithsingleandtwinpegfemoralcomponentsbasedondatafromthenationaljointregistryforenglandwalesnorthernirelandandtheisleofman AT murraydw amatchedcomparisonofrevisionratesofcementedoxfordunicompartmentalkneereplacementswithsingleandtwinpegfemoralcomponentsbasedondatafromthenationaljointregistryforenglandwalesnorthernirelandandtheisleofman AT mohammadhr matchedcomparisonofrevisionratesofcementedoxfordunicompartmentalkneereplacementswithsingleandtwinpegfemoralcomponentsbasedondatafromthenationaljointregistryforenglandwalesnorthernirelandandtheisleofman AT matharugs matchedcomparisonofrevisionratesofcementedoxfordunicompartmentalkneereplacementswithsingleandtwinpegfemoralcomponentsbasedondatafromthenationaljointregistryforenglandwalesnorthernirelandandtheisleofman AT judgea matchedcomparisonofrevisionratesofcementedoxfordunicompartmentalkneereplacementswithsingleandtwinpegfemoralcomponentsbasedondatafromthenationaljointregistryforenglandwalesnorthernirelandandtheisleofman AT murraydw matchedcomparisonofrevisionratesofcementedoxfordunicompartmentalkneereplacementswithsingleandtwinpegfemoralcomponentsbasedondatafromthenationaljointregistryforenglandwalesnorthernirelandandtheisleofman |