title: Knee arthroplasty with a medial rotating total knee replacement. Midterm clinical findings: a district general experience of 38 cases.
abstract: BACKGROUND
  The Medial Rotating Knee replacement (MRK) was first used in 1994, reporting high rates of satisfaction. It is designed to replicate natural knee kinematics and improve stability and function. There are limited studies on the mid-term clinical outcomes, in particular in a district general hospital (DGH) environment. This is the first study that we are aware of that evaluates the learning curve of the implementation of this knee system in this environment.
  
  
  METHODS
  Between 2007 and 2009 we performed 38 consecutive MRK replacements (MAT ORTHO, UK) in 36 patients. The mean follow-up was four years. Patients were evaluated clinically, using OKS and patient questionnaire and radiographically (good/acceptable/poor) to assess outcome.
  
  
  RESULTS
  Mean age was 73.0 years. Mean pre-operative OKS was 17.7 (range 8-29), which rose to 38.1 (range 23-48) at latest follow up (p<0.005). Overall 71% of the patients were either satisfied (29%) or very satisfied (42%). 81% felt an improvement of the ability to go up or down stairs and 92% felt stable. All poor radiographic and the majority of acceptable outcomes were experienced in the first 50% of cases.
  
  
  CONCLUSIONS
  The MRK can be successfully implanted in a DGH environment. It improves pain and function comparably to standard TKRs, however, subjective improvement may be higher. Radiographic evaluation shows an acceptable learning curve.
  
  
  METHODS
  Level IV case series.
authors.affiliation: Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom. Electronic address: Sam.jonas@doctors.org.uk.
authors.forename: Sam C
authors.initials: SC
authors.lastname: Jonas
authors.affiliation: Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom.
authors.forename: Miltiadis
authors.initials: M
authors.lastname: Argyropoulos
authors.affiliation: Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom.
authors.forename: Nawfal
authors.initials: N
authors.lastname: Al-Hadithy
authors.affiliation: Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom.
authors.forename: Marius
authors.initials: M
authors.lastname: Korycki
authors.affiliation: Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom.
authors.forename: Benedict
authors.initials: B
authors.lastname: Lotz
authors.affiliation: Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom.
authors.forename: Sunny D
authors.initials: SD
authors.lastname: Deo
authors.affiliation: Great Western Hospital, Marlborough Road, Swindon SN3 6BB, United Kingdom.
authors.forename: Venkat
authors.initials: V
authors.lastname: Satish
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005500:Follow-Up Studies; D006769:Hospitals, General; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D007720:Knee Prosthesis; D059032:Learning Curve; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Clinical outcome; Learning curve; Medial rotation knee replacement