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The cementless Oxford unicompartmental knee replacement has been demonstrated to have superior fixation on radiographs and a similar early complication rate compared with the cemented version. However, a small number of cases have come to our attention where, after an apparently successful procedure, the tibial component subsides into a valgus position with an increased posterior slope, before becoming well-fixed. We present the clinical and radiological findings of these six patients and describe their natural history and the likely causes. Two underwent revision in the early post-operative period, and in four the implant stabilised and became well-fixed radiologically with a good functional outcome. This situation appears to be avoidable by minor modifications to the operative technique, and it appears that it can be treated conservatively in most patients.

Original publication




Journal article


Bone joint j

Publication Date





345 - 349


Arthroplasty, Cementless fixation, Hydroxyapatite, Loosening, Revision, Unicompartmental knee replacement, Aged, Arthroplasty, Replacement, Knee, Female, Humans, Knee Prosthesis, Male, Middle Aged, Osteoarthritis, Knee, Postoperative Complications, Prosthesis Design, Radiography, Reoperation, Tibia, Treatment Failure, Treatment Outcome