PURPOSE Unicompartmental knee replacement (UKR) has substantial benefits over total knee replacement (TKR) but has higher revision rates. The cementless Oxford UKR was introduced to address this but there are concerns about fixation and tibial plateau fractures. The first long-term study of the device with clinical and radiographic outcomes is reported. METHODS The first 1000 medial cementless Oxford UKR were prospectively identified and followed up by independent physiotherapists. Survival was calculated using the endpoints reoperation, revision, revision to TKR, major revision requiring revision TKR components and patient mortality. The Oxford Knee Score (OKS), Tegner Activity Score and American Knee Society Score (AKSS) were recorded and radiographs analysed. RESULTS The ten year survival was 96.6% (CI 94.8-97.8), 97.5% (CI 95.7-98.5), 98.9% (CI 97.7-99.4) and 99.6% (CI 98.8-99.9) using reoperation, revision, revision to TKR and major revision as the endpoint, respectively. Commonest causes for revision were bearing dislocation (n = 7, 0.7%), disease progression (n = 4, 0.4%) and pain (n = 2, 0.2%). There was one lateral tibial plateau fracture and one femoral component loosening. At 10 years, the mean OKS was 41.2 (SD 9.8), Tegner 2.8 (SD 1.3), AKSS-O 89.1 (SD 13.0) and AKSS-F 80.4 (SD 14.6). There were no pathological radiolucencies or complete radiolucent lines. There were no implant-related deaths. CONCLUSIONS The cementless Oxford UKR is a safe procedure with excellent long-term clinical results. Our results suggest that reliable fixation was achieved with only one (0.1%) revision for loosening (femoral), no radiographic evidence of loosening in the remaining cases and no fractures related to implantation. LEVEL OF EVIDENCE III.

中文翻译：

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1000例非胶粘牛津单室膝关节置换手术的十年临床和影像学结果。

目的单室膝关节置换术（UKR）优于全膝关节置换术（TKR），但翻修率更高。引入了非骨水泥牛津UKR来解决此问题，但存在对固定和胫骨平台骨折的担忧。据报道该装置具有临床和放射学结果的首次长期研究。方法前瞻性鉴定了首批1000例非骨水泥牛津UKR，并由独立的物理治疗师进行了随访。使用终点再手术，修订，对TKR的修订，需要修订TKR组件的主要修订和患者死亡率来计算生存率。记录牛津膝关节评分（OKS），特格纳活动评分和美国膝关节学会评分（AKSS）并进行X线分析。结果十年生存率分别为96.6％（CI 94.8-97.8），97.5％（CI 95.7-98.5），98。以重新操作，修订，对TKR的修订和主要修订为终点，分别为9％（CI 97.7-99.4）和99.6％（CI 98.8-99.9）。翻修的最常见原因是轴承脱位（n = 7，0.7％），疾病进展（n = 4，0.4％）和疼痛（n = 2，0.2％）。胫骨外侧平台骨折1例，股骨组件松动1例。在10年时，平均OKS为41.2（SD 9.8），Tegner 2.8（SD 1.3），AKSS-O 89.1（SD 13.0）和AKSS-F 80.4（SD 14.6）。没有病理学上的X线透视或完整的射线可透线。没有与植入物相关的死亡。结论非骨水泥牛津UKR是一种安全的方法，具有出色的长期临床效果。我们的结果表明，仅通过一次（0.1％）翻修（股骨）松动即可获得可靠的固定，其余病例均无放射线证据显示松动，也没有与植入有关的骨折。证据级别III。