Adequate Positioning of the Tibial Component Is Key to Avoiding Bearing Impingement in Oxford Unicompartmental Knee Arthroplasty

Bearing dislocation is a serious complication of unicompartmental knee arthroplasty (UKA) with the Oxford knee prosthesis equipped with a mobile bearing. We aimed to clarify the extent of intraoperative movement of the mobile bearing and its relationship with the positioning of prosthesis components in patients undergoing Oxford UKA.

This retrospective study included 50 patients (50 knees) who underwent Oxford UKA for anteromedial osteoarthritis or osteonecrosis of the knee. Intraoperative bearing movement was assessed at various angles of knee flexion (0°, 30°, 60°, 90°, and 120°). We stratified patients according to the extent of bearing movement posteriorly during intraoperative knee flexion, with or without contacting the lateral wall of the tibial component (with contact, 20 knees; without contact, 30 knees). Postoperative radiographic evaluations were conducted at 1 week postoperatively to assess the positional parameters of the tibial and femoral components (varus/valgus alignment, rotation, mediolateral position). Clinical evaluations were conducted at 1 year postoperatively (maximum flexion angle, Oxford Knee Score).

Abnormal intraoperative movement of the mobile bearing resulting in contact with the lateral wall of the tibial component was associated with a significantly more medial position and external rotation of the tibial component, as well as poorer improvement in knee flexion angle at 1 year postoperatively.

In Oxford UKA recipients, the bearing may impinge on the lateral wall of the tibial component during flexion above 60° if the tibial component is placed too medially or exhibits pronounced external rotation, which may limit knee function improvement postoperatively.