Do you know of patients that have been excluded from partial knee replacement because they were too young or too old for it? Clinical papers have reported the positive outcomes of Oxford PKR in patients of all ages; from the under 50s to the over 75s. These data suggest that when it comes to partial knees, age really is just a number. 1, 2, 3
Narrow Age Range – Young patients
Kennedy et al. 2 found no difference in 10-year Oxford implant survivorship between patients in four age groups (<55, 55 to <65, 65 to <75, and ≥75). The cumulative 10-year UKA survival rate for those younger than 55 was 97.2%. While Price et al. 1 found that the ten-year all-cause survival of the Oxford PKR in patients of < 60 years was 91%. According to the authors, The Swedish Knee Arthroplasty Register (SKAR) reported a ten-year cumulative survival rate of about 90% for TKRs performed for OA on patients < 65 years of age (SKAR 2004)4
PKR should only be considered in patients with AMOA (bone on bone in the medial compartment, with a functionally intact ACL, normal LCL and MCL, and full thickness cartilage in the lateral compartment). It is not an option for young patients with less severe arthritis, only young patients with AMOA.
Narrow Age Range – Older patients
The literature suggests that older patients could gain the most from PKR. Siman et al. 20175 concluded that, “due to its less invasive nature, patients older than 75 undergoing UKA demonstrated faster initial recovery when compared to TKA while maintaining comparable complications and midterm survivorship.” They recommended that “UKA should be offered as an option in the elderly patient who fits the selection criteria for UKA.” While in patients over 75 years, Fabre-Aubrespy (2016)6 showed that PKR provided higher function and better forgotten joint scores with similar survivorship compared to TKR, and Liddle et al. (2014)7 concluded that “older patients (≥ 75), who are least likely to be offered UKR, may derive the greatest benefits.”