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Oxford Knee Replacement

Harvey Black reminisces: “20 years ago, I tore cartilage in my knee playing tennis. I had arthroscopy and I was playing tennis again a few days later.”

“It was great, but nobody told me it was just a long-term band-aid. It swelled constantly. I had to ice it and take anti-inflammatories. Eventually, I had to abandon tennis.”

“I was a teaching pro. That’s how I got through university. Tennis was part of my life. Giving up tennis was difficult. Now I might play again!”

Black says this last sentence exuberantly. Dr. James Rathbun, orthopaedic surgeon at The Scarborough Hospital (TSH), told Black he will recover from his upcoming Oxford unicompartmental knee replacement in six weeks, not the six months it takes for a full knee replacement.

Rathbun, the doctor who brought this procedure to The Scarborough Hospital, where he performed North America’s first Oxford knee replacement, understands Black’s hopes. “I’ve had people with arthritic knees go back to activities like hockey and tennis pain-free,” he says. (please clarify that Rathbun performed North America’s first Oxford knee surgery at TSH)

“When I heard about the Oxford knee, I was impressed,” Rathbun continues. “I went to England, did the course and started doing Oxfords when I got back.” TSH staff now do more Oxford knee replacements than any other hospital in Canada.

Rathbun explains the procedure he’s done more than 500 times. “We add three pieces to one side of the knee joint. We fit a rounded convex alloy plate to the base of the femur (thighbone) and a flat plate to the top of the tibia (shinbone). Between the two, we insert a plastic mobile bearing to replace the worn meniscus. The top of the bearing is concave so it fits with the convex upper (femoral) plate. The whole assembly lets the bearing slide between the two plates.”

Rathbun pulls out a container full of broken metal and worn plastic to make a point.

“Unlike these broken prostheses, the Oxford pieces hardly wear over time,” Rathbun says, “since the bearing slides between the two bones, not just one. That’s a lot less friction on the bearing.”

The Oxford University designers of this procedure have refined it over time. Today’s patients get the Oxford Phase 3. Key upgrades include different sizes of plates and bearings for different-size knees. “We can put this into a gorilla or a minute little lady,” Rathbun says.

Rathbun lauds the whole operation, not just the pieces. “I can tell from X-rays whether a patient needs this procedure – I don’t need to do arthroscopy. It’s a one-hour operation, there’s a much smaller cut and we don’t move the kneecap out of the way. Patients wake up with less, if any, pain, they’re out of the hospital in half the time, and rehabilitation is much quicker.”

“The Brits have been putting these things in people for 15 to 20 years,” Rathbun says. “After long-term follow-up with 130 patients, they recorded a 98 per cent success rate.”

That’s music to Black’s ears. “I might just hit a few balls in Florida this fall!” Rathbun adds: “The vast majority of patients are very happy. They can walk normally again.”

9 Comments
  1. I had an Oxford Knee Replacement performed in 2003 in Belleville General Hospital, performed by Dr. Dan Steinitz. If Dr. Rathbun performed his first Oxford Knee Replacement in 2008, it was definitely not the first one performed in Canada.

    • Thanks for your comment. I re-published this article on my website several years after I wrote it for a community newspaper. This article was originally published in 2005. Sorry for any misunderstanding. I would link to the original but I can’t seem to find it online.

  2. I’ve had both knees done by Dr Rathbun and have had no problems at all, it’s been 4 years now. No more pain 🙂

    • I’m happy to hear that, Joceline! Here’s to many years of pain-free mobility!

  3. I have had three Oxford knee replacements by Dr Rathbun on my right knee and
    the 1st one was 13 years ago and it
    is still going strong
    The left knee was done last May
    And the right one on the outside 2 weeks ago
    I am walking unaided and normally
    The swelling is minimal and I have been given permission to drive
    I do Pilates yoga and swim
    I am 79 years old and fit because of it
    I can only say that if you listen tonDr Rathbun ‘s advice
    And do your exercises diligently before surgery you will recover very fast
    He is the best

    • I’m happy to hear that, Rochelle! I hope you enjoy your “knee health” for many more years.

  4. I have also had three partial replacements all done by Dr. Rathbun. I had the first (inner joint) done in Dec 2008 and the second (inner joint) in June 2009, at 61 years. No other Orthopedic Surgeon would touch my knees, even when the X-rays showed they were bone on bone. I was in constant pain and all they wanted to do was give me pills. I was referred to him by another doctor I was seeing at Scarborough General. He changed my life or I probably should say he saved my life. They are still working perfectly and I had a third one(outer left) done May of 2019 at the age of 71. I was up and walking three hours after the surgery with a crutch and back to work within 2 weeks. At physio you can see the difference in the recoup time with the Oxford compared to a full replacement. I can not sing his praises enough! Follow his protocol and you will be a different person. In fact today I am going to see him for my follow-up after the May surgery.

  5. Dr. James Rathbun–thank God for him! He has amazing talent and skill and can determine what your knee problem is in less than 30 seconds. Here’s the best part–after he tells you what is wrong he is then able to fix it! (Not the same day of course) I have had two Oxfords and you would think I never had any–my knees are as good as they were years ago. The Oxford replacement is the way to go if possible–you’re up and around in no time and the recovery period is much shorter (and less painful) than the full knee treatment. The post-procedure exercises aren’t a lot of fun but it is important to do them diligently. Thank you Dr. James for doing what you do.

  6. Is Dr Rathbun stiil doing the Oxford Uni’s during COVID? I noticed that Richard Watson (Nov 29, 2021) commented about this AMAZING doctor and was wondering if he is still taking appointments to do the procedure presently. I had one knee done in 2018 and need to have the other done but I am not sure if he is able to do them still.

    BTW I have nothing but THE BEST to say about this wonderful man. He is a God-send for knee sufferers ! !