A Single Surgeon, 10 Year Experience with the Oxford Partial Knee System: What a Difference Experience, Instruments, Implants, and Technique Can Make


  • David Mauerhan Carolinas HealthCare System
  • Nigel L Rozario Carolinas HealthCare System




partial knee arthroplasty, PKA, Oxford Partial Knee Replacement


Partial knee (unicompartmental) arthroplasty (PKA) for medial compartment disease of the knee has a long and well documented history of successful results over long periods of follow up. The Oxford Partial Knee Replacement has been available in the U.S. since 2004. After completing an FDA required instructional course, surgeons may use the device. Both the implant and the instruments have evolved since its introduction in 2004. This paper outlines the authors continuous cohort of 249 patients, 286 knees from 2004 to 2014 with minimum 2 year follow up, and reports the results while discussing the impact of experience, instruments and implants, and technique on the outcome of patients in this series. For the aggregate group of 286 knees, there were 17(5.9%) all-cause revisions to TKA, including 2(0.7%) dislocations, resulting in a (83%) survivorship at ten years. The survivorship at ten years for retained implants was 97% if non-implant related causes are not included. At one year, there were 89% excellent and good results, 5% fair, and 6% poor. At two years, there were 93% excellent and good, 1 % fair, and 5.5% poor.  The causes for the poor results at one and two years were tibial sided failure or persistent pain. Three (12%) of patients with a poor result at one year had converted to good and excellent at two years. The use of the Oxford Mobile Bearing™ PKA has been shown to be a useful part of the surgeon’s surgical armamentarium when dealing with anteromedial osteoarthritis or osteonecrosis of the knee. PKA has been shown to have a lower morbidity and mortality and is cost effective when compared to total knee arthroplasty. The author’s experience, as demonstrated in this study, adds validity to the concept that understanding the pathoanatomy of anteromedial osteoarthritis and gaining surgical experience through increased surgical volume, adherence to well documented technique, and the use of a time proven implant, can be accomplished with a high degree of successful outcomes for patients with the appropriate indications.

Author Biographies

David Mauerhan, Carolinas HealthCare System


Nigel L Rozario, Carolinas HealthCare System



Price AJ, Svard U.: A second decade lifetable survival analysis of the Oxford unicompartmental knee

arthroplasty. Clin Orthop Relat Res. 2011 Jan;469(1): 174-9.

Jones, L. et al. 10 Year survivorship of the medial Oxford unicompartmental knee arthroplasty. A 1000 patient non-designer series - the effect of surgical grade and supervision. Osteoarthritis and Cartilage Volume 20, Supplement 1, Pages S290–S291, April 2012.

Deshmukh, RV, Scott, RD. “Unicompartmental knee arthroplasty: long-term results.” Clin Orthop and Relat Res. 2001; 392:272-278.

Liddle, A.D., et al. “Adverse outcomes after total and unicompartmental knee replacement in 101 330 matched patients: a study of data from the National Joint Registry for England and Wales.” The Lancet 384.9952 (2014): 1437-1445.

White, S. H., et al. “Anteromedial osteoarthritis of the knee.” J Bone Joint Surg Br, 73 (1991): 582-586

Goodfellow J. Unicompartmental arthroplasty with the Oxford knee. Oxford: Goodfellow, 2011.

Kozinn, S., Scott, R. Unicondylar Knee Arthroplasty. J Bone and Joint Surg A,71. (1989).

Murray, D. W., et al. “The Oxford medial unicompartmental arthroplasty a ten-year survival study.”

J bone Joint Surg Br, 80.6 (1998): 983-989.

Lewold, Stefan, et al. “Oxford meniscal bearing knee versus the Marmor knee in unicompartmental

arthroplasty for arthrosis: A Swedish multicenter survival study.” J Arthroplasty 10.6 (1995):722-731.

Argenson, J.N., et al. Comparison of 4 Centers Using Oxford Partial Knee. Presented at EFORT 1988.

Gulati A, et al. the effect of leg alignment on the outcome of unicompartmental knee replacement. J Bone Joint Surg Br, 91(4); 469, 2009.

Keyes, G.W., et al. “The radiographic classification of medial gonarthrosis: correlation with operation

methods in 200 knees.” Acta Orthopaedica 63.5 (1992): 497-501.

Pandit, et al. Unnecessary Contraindications for MB UKR. J Bone Joint Surg Br,93 (2011(:622-628.

Langdown, A.J., et al. “Oxford medial unicompartmental arthroplasty for focal spontaneous osteonecrosis of the knee.” Acta Orthopaedica 76.5 (2005): 688-692.

Choy, Won-Sik, et al. “Medial unicompartmental knee arthroplasty in patients with spontaneous osteonecrosis of the knee.” Clinics in Orthopedic Surgery 3.4 (2011): 279-284.

Berend KR, Berend ME, Dalury DF, Argenson J-N, Dodd CA, Scott RD. consensus Statement on Indications and contraindications for Medial Unicomparmental Knee Arthroplasty. Journal of Surgical Orthopaedic Advances 24(4): 252, 2015.

Bozic KJ, et al. the influence of procedure volumes and standardization of care on quality and efficiency in total joint replacement surgery. J Bone Joint Surg Am 2010 Nov 17;92(16) 2643-52.

Hervey SL, et al. Provider volume of total knee arthroplasties and patient outcomes in HCUP-Nationwide Inpatient Sample. J Bone Joint Surg Am. 2003 Sep;85-A (9):1775-83.

Lau RL. Et al. The role of surgeon volume on patient outcome in total knee arthroplasty: a systemic review of the literature. BMC Musculoskelet Disord. 2012; 13: 250.

Trent Register. UK. Presentation by Esler, C., Unicompartmental Knee Arthroplasty - Results from a UK Joint Register. Oxford & Bristol Unicompartmental Meet. November 2008.

Liddle Ad, Pandit H, Judge A, Murray DW. Optimal usage of unicompartmental knee arthroplasty: a study of 41,986 cases from the National Joint Registry for England and Wales. Bone & Joint Journal 97-B (11): 1506, 2015.

Small, et al. Metal Backing Significantly Decreases Tibial Strains in a Medial Unicompartmental Knee

Arthroplasty Model. J Arthroplasty 2011 26(5):777.

Small, et al. Bearing Mobility Affects Tibial Strain in Mobile-Bearing Unicompartmental Knee Arthroplasty. Surg. Technol Int, 2010;19:185.

Small, et al. Tibial Loading after UKA: Evaluation of tibial slope, Resection Depth, Medial Shift and Component Rotation. J Arthroplasty 2013 28 Suppl. 2 179-183.

Hurst, Jason M., et al. “Radiographic Comparison of Mobile-Bearing Partial Knee Single-Peg versus

Twin-Peg Design.” J Arthroplasty 2014 30(3):475-478.

Faour-Martin O., et al. Oxford phase 3 unicondylar knee arthroplasty through a minimally invasive approach: long term results. Int Orthop 37(5); 833, 2013.

Yoshida K, et al. Oxford phase 3 unicompartmental knee arthroplasty in Japan- clinical results in greater than one thousand cases over ten years. J Arthroplasty 2013 28(9 Suppl): 168.

Lim HC, et al. Oxford phase 3 unicompartmental replacement in Korean patients. J Bone Joint Surg Br 94(8): 1071, 2012.

Mauerhan, DR, et al. The Patient Directed Valgus Stress Radiograph of the Knee: A New and Novel Technique. Am J Orthop. 2016 January;45(1),44-46.

Bolognesi M, et al. Unicompartmental Knee Arthroplasty and Total Knee Arthroplasty Among Medicare Beneficiaries, 2000 to 2009J Bone Joint Surg Am, 2013; 95: e174(1-9).

Brown, et al. Total Knee Arthroplasty Has Higher Postoperative Morbidity than Unicompartmental Knee Arthroplasty: A Multicenter Analysis. J Arthroplasty 2012 8(Suppl 1):86.

SooHoo, NF et al. Cost-effectiveness analysis of unicompartmental knee arthroplasty as an alternative to total knee arthroplasty for unicompartmental osteoarthritis. J Bone Joint Surg Am, 2006 88(9): 1975.

Ghomrawi, HM, et al. Effect of Age on cost-effectivness of unicompartmental knee arthroplasty compared with total knee arthroplasty in the U.S. J Bone Joint Surg Am, 2015 97(5): 396




How to Cite

Mauerhan, D., & Rozario, N. L. (2017). A Single Surgeon, 10 Year Experience with the Oxford Partial Knee System: What a Difference Experience, Instruments, Implants, and Technique Can Make. Reconstructive Review, 7(2). https://doi.org/10.15438/rr.7.2.180



Original Article