Survivorship and Clinical Outcome of the Minimally Invasive Uniglide Medial Fixed Bearing, All-polyethylene Tibia, Unicompartmental Knee Arthroplasty at a Mean Follow-up of 7.3 Years

Background: Medial UKA performed in England and Wales represents 7 to 11% of all knee arthroplasty procedures, and is most commonly performed using mobile-bearing designs. Fixed bearing eliminates the risk of bearing dislocation, however some studies have shown higher revision rates for all-polyethylene tibial components compared to those that utilize metal-backed implants. The aim of the study is to analyse survivorship and maximum 8-year clinical outcome of medial fixed bearing, Uniglide unicompartmental knee arthroplasty performed using an all-polyethylene tibial component with a minimal invasive approach. Methods: Between 2002 and 2009, 270 medial fixed UKAs were performed in our unit. Patients were reviewed pre-operatively, 5 and 8 years post-operatively. Clinical and radiographic reviews were carried out. Patients’ outcome scores (Oxford, WOMAC and American Knee Score) were documented in our database and analysed. Results: Survival and clinical outcome data of 236 knees with a mean 7.3 years follow-up are reported. Every patient with less than 4.93 years follow-up underwent a revision. The patients’ average age at the time of surgery was 69.5 years. The American Knee Society Pain and Function scores, the Oxford Knee Score and the WOMAC score all improved significantly. The 5 years survival rate was 94.1% with implant revision surgery as an end point. The estimated 10 years survival rate is 91.3%. 14 patients were revised before the 5 year follow-up. Conclusion: Fixed bearing Uniglide UKA with an all-polyethylene tibial component is a valuable tool in the management of a medial compartment osteoarthritis, affording good short term survivorship.

What Attitude Changes Are Needed to Cause SMEs to Take a Strategic Approach to Information Security?

Spending on security in an SME usually has to compete with demands for hardware, infrastructure, and strategic applications. In this paper, the authors seek to explore the reasons why smaller SMEs in particular have consistently failed to see securing information as strategic year-on-year spending, and just regard as part of an overall tight IT budget. The authors scrutinise the typical SMEs reasoning for choosing to see non-spending on security as an acceptable strategic risk. They look particularly at possible reasons why SMEs tend not to take much notice of "scare stories" in the media based on research showing they are increasingly at risk, whilst larger businesses are taking greater precautions and become more difficult to penetrate. The results and their analysis provide useful pointers towards broader business environment changes that would cause SMEs to be more risk-averse and ethical in their approach to securing their own and their clients’ information.