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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
N
N
Bottomley
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
L D
LD
Jones
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
R
R
Rout
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
A
A
Alvand
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
I
I
Rombach
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
T
T
Evans
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
W F M
WF
Jackson
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
D J
DJ
Beard
NDORMs, University of Oxford, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
A J
AJ
Price
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000193:education / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D002983:Clinical Competence; D003253:Consultants; D004503:Education, Medical, Graduate; D004739:England; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D016019:Survival Analysis; D062606:Tertiary Care Centers / Q000592:standards / Q000706:statistics & numerical data; D016896:Treatment Outcome
Arthroplasty; Knee; Partial; Survival; Trainee
J Arthroplasty. 2009 Dec;24(8):1281-4
19729271
Knee Surg Sports Traumatol Arthrosc. 2006 Jan;14(1):40-5
15895294
J Bone Joint Surg Br. 1991 Jul;73(4):582-6
2071640
J Bone Joint Surg Am. 2016 Jan 6;98(1):1-8
26738897
Knee Surg Sports Traumatol Arthrosc. 2007 Nov;15(11):1331-4
17684726
J Bone Joint Surg Br. 1997 Mar;79(2):254-7
9119852
Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1895-901
23996106
Bone Joint J. 2015 Nov;97-B(11):1506-11
26530653
J Bone Joint Surg Br. 1993 Sep;75(5):697-704
8376423
J Arthroplasty. 2016 May;31(5):1016-21
26725134
J Bone Joint Surg Br. 2009 Jul;91(7):928-34
19567859
Clin Orthop Relat Res. 2012 Jan;470(1):61-8
21732024
J Bone Joint Surg Br. 2001 Jan;83(1):45-9
11245537
J Bone Joint Surg Br. 1998 Nov;80(6):983-9
9853489
Acta Orthop. 2011 Apr;82(2):131-5
21434760
Clin Orthop Relat Res. 2005 Jun;(435):171-80
15930935
J Bone Joint Surg Br. 2011 Feb;93(2):198-204
21282759
Bone Joint J. 2016 Mar;98-B(3):301-6
26920953
Clin Orthop Relat Res. 2012 Jan;470(1):84-90
22038173
Knee Surg Sports Traumatol Arthrosc. 2013 Nov;21(11):2495-500
23179453
J Bone Joint Surg Br. 2005 Nov;87(11):1488-92
16260664
J Bone Joint Surg Br. 2012 Jul;94(7):919-27
22733946