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The Bone & Joint Journal
Vol. 102-B, Issue 7 | Pages 950 - 958
1 Jul 2020
Dakin H Eibich P Beard D Gray A Price A

Aims

To assess how the cost-effectiveness of total hip arthroplasty (THA) and total knee arthroplasty (TKA) varies with age, sex, and preoperative Oxford Hip or Knee Score (OHS/OKS); and to identify the patient groups for whom THA/TKA is cost-effective.

Methods

We conducted a cost-effectiveness analysis using a Markov model from a United Kingdom NHS perspective, informed by published analyses of patient-level data. We assessed the cost-effectiveness of THA and TKA in adults with hip or knee osteoarthritis compared with having no arthroplasty surgery during the ten-year time horizon.


Bone & Joint Research
Vol. 9, Issue 1 | Pages 15 - 22
1 Jan 2020
Clement ND Bell A Simpson P Macpherson G Patton JT Hamilton DF

Aims

The primary aim of the study was to compare the knee-specific functional outcome of robotic unicompartmental knee arthroplasty (rUKA) with manual total knee arthroplasty (mTKA) for the management of isolated medial compartment osteoarthritis. Secondary aims were to compare length of hospital stay, general health improvement, and satisfaction between rUKA and mTKA.

Methods

A powered (1:3 ratio) cohort study was performed. A total of 30 patients undergoing rUKA were propensity score matched to 90 patients undergoing mTKA for isolated medial compartment arthritis. Patients were matched for age, sex, body mass index (BMI), and preoperative function. The Oxford Knee Score (OKS) and EuroQol five-dimension questionnaire (EQ-5D) were collected preoperatively and six months postoperatively. The Forgotten Joint Score (FJS) and patient satisfaction were collected six months postoperatively. Length of hospital stay was also recorded.


The Bone & Joint Journal
Vol. 101-B, Issue 2 | Pages 213 - 220
1 Feb 2019
Xu S Lim WJ Chen JY Lo NN Chia S Tay DKJ Hao Y Yeo SJ

Aims

The aim of this study was to assess the influence of obesity on the clinical outcomes and survivorship ten years postoperatively in patients who underwent a fixed-bearing unicompartmental knee arthroplasty (UKA).

Patients and Methods

We prospectively followed 184 patients who underwent UKA between 2003 and 2007 for a minimum of ten years. A total of 142 patients with preoperative body mass index (BMI) of < 30 kg/m2 were in the control group (32 male, 110 female) and 42 patients with BMI of ≥ 30 kg/m2 were in the obese group (five male, 37 female). Pre- and postoperative range of movement (ROM), Knee Society Score (KSS), Oxford Knee Score (OKS), 36-Item Short-Form Health Survey (SF-36), and survivorship were analyzed.


The Bone & Joint Journal
Vol. 102-B, Issue 8 | Pages 1033 - 1040
1 Aug 2020
Kennedy JA Mohammad HR Yang I Mellon SJ Dodd CAF Pandit HG Murray DW

Aims

To report mid- to long-term results of Oxford mobile bearing domed lateral unicompartmental knee arthroplasty (UKA), and determine the effect of potential contraindications on outcome.

Methods

A total of 325 consecutive domed lateral UKAs undertaken for the recommended indications were included, and their functional and survival outcomes were assessed. The effects of age, weight, activity, and the presence of full-thickness erosions of cartilage in the patellofemoral joint on outcome were evaluated.


The Bone & Joint Journal
Vol. 101-B, Issue 8 | Pages 941 - 950
1 Aug 2019
Scott CEH MacDonald DJ Howie CR

Aims

The EuroQol five-dimension (EQ-5D) questionnaire is a widely used multiattribute general health questionnaire where an EQ-5D < 0 defines a state ‘worse than death’ (WTD). The aim of this study was to determine the proportion of patients awaiting total hip arthroplasty (THA) or total knee arthroplasty (TKA) in a health state WTD and to identify associations with this state. Secondary aims were to examine the effect of WTD status on one-year outcomes.

Patients and Methods

A cross-sectional analysis of 2073 patients undergoing 2073 THAs (mean age 67.4 years (sd 11.6; 14 to 95); mean body mass index (BMI) 28.5 kg/m2 (sd 5.7; 15 to 72); 1253 female (60%)) and 2168 patients undergoing 2168 TKAs (mean age 69.3 years (sd 9.6; 22 to 91); BMI 30.8 kg/m2 (sd 5.8; 13 to 57); 1244 female (57%)) were recorded. Univariate analysis was used to identify variables associated with an EQ-5D score < 0: age, BMI, sex, deprivation quintile, comorbidities, and joint-specific function measured using the Oxford Hip Score (OHS) or Oxford Knee Score (OKS). Multivariate logistic regression was performed. EQ-5D and OHS/OKS were repeated one year following surgery in 1555 THAs and 1700 TKAs.


The Bone & Joint Journal
Vol. 100-B, Issue 12 | Pages 1572 - 1578
1 Dec 2018
Middleton R Wilson HA Alvand A Abram SGF Bottomley N Jackson W Price A

Aims

Our unit was identified as a negative outlier in the national patient-reported outcome measures (PROMs) programme, which has significant funding implications. As a centre that carries out a high volume of unicompartmental knee arthroplasty (UKA), our objectives were: 1) to determine whether the PROMs programme included primary UKA when calculating the gain in Oxford Knee Score (OKS); and 2) to determine the impact of excluding primary UKA on calculated OKS gains for primary knee arthroplasty.

Materials and Methods

National PROMs data from England (2012 to 2016) were analyzed. Inclusion of UKA cases in the national PROMs programme was determined using clinical codes. Local OKS gain was calculated for UKA and TKA and compared with the published PROMs results for 2012/13.


Bone & Joint Research
Vol. 7, Issue 5 | Pages 351 - 356
1 May 2018
Yeoman TFM Clement ND Macdonald D Moran M

Objectives. The primary aim of this study was to assess the reproducibility of the recalled preoperative Oxford Hip Score (OHS) and Oxford Knee Score (OKS) one year following arthroplasty for a cohort of patients. The secondary aim was to assess the reliability of a patient’s recollection of their own preoperative OHS and OKS one year following surgery. Methods. A total of 335 patients (mean age 72.5; 22 to 92; 53.7% female) undergoing total hip arthroplasty (n = 178) and total knee arthroplasty (n = 157) were prospectively assessed. Patients undergoing hip and knee arthroplasty completed an OHS or OKS, respectively, preoperatively and were asked to recall their preoperative condition while completing the same score one year after surgery. Results. A mean difference of 0.04 points (95% confidence intervals (CI) -15.64 to 15.72, p = 0.97) between the actual and the recalled OHS was observed. The mean difference in the OKS was 1.59 points (95% CI -11.57 to 14.75, p = 0.10). There was excellent reliability for the ‘average measures’ intra-class correlation for both the OHS (r = 0.802) and the OKS (r = 0.772). However, this reliability was diminished for the individuals OHS (r = 0.670) and OKS (r = 0.629) using single measures intra-class correlation. Bland–Altman plots demonstrated wide variation in the individual patient’s ability to recall their preoperative score (95% CI ± 16 for OHS, 95% CI ± 13 for OKS). Conclusion. Prospective preoperative collection of OHS and OKS remains the benchmark. Using recalled scores one year following hip and knee arthroplasty is an alternative when used to assess a cohort of patients. However, the recall of an individual patient’s preoperative score should not be relied upon due to the diminished reliability and wide CI. Cite this article: T. F. M. Yeoman, N. D. Clement, D. Macdonald, M. Moran. Recall of preoperative Oxford Hip and Knee Scores one year after arthroplasty is an alternative and reliable technique when used for a cohort of patients. Bone Joint Res 2018;7:351–356. DOI: 10.1302/2046-3758.75.BJR-2017-0259.R1


The Bone & Joint Journal
Vol. 101-B, Issue 1 | Pages 41 - 46
1 Jan 2019
Clement ND Howard TA Immelman RJ MacDonald D Patton JT Lawson GM Burnett R

Aims

The primary aim of this study was to compare the knee-specific functional outcome of patellofemoral arthroplasty with total knee arthroplasty (TKA) in the management of patients with patellofemoral osteoarthritis.

Patients and Methods

A total of 54 consecutive Avon patellofemoral arthroplasties were identified and propensity-score-matched to a group of 54 patients undergoing a TKA with patellar resurfacing for patellofemoral osteoarthritis. The Oxford Knee Score (OKS), the 12-Item Short-Form Health Survey (SF-12), and patient satisfaction were collected at a mean follow up of 9.2 years (8 to 15). Survival was defined by revision or intention to revise.


The Bone & Joint Journal
Vol. 100-B, Issue 9 | Pages 1168 - 1174
1 Sep 2018
Zhang L Lix LM Ayilara O Sawatzky R Bohm ER

Aims

The aim of this study was to assess the effect of multimorbidity on improvements in health-related quality of life (HRQoL) following total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Patients and Methods

Using data from a regional joint registry for 14 573 patients, HRQoL was measured prior and one year following surgery using the Oxford Hip Score (OHS) and Oxford Knee Score (OKS), and the 12-Item Short-Form Health Survey Physical and Mental Component Summary scores (PCS and MCS, respectively). Multimorbidity was defined as the concurrence of two or more self-reported chronic conditions. A linear mixed-effects model was used to test the effects of multimorbidity and the number of chronic conditions on improvements in HRQoL.