Partial Knee Replacements May Be Better for Patients
Partial knee replacements could be better than full replacements for many patients, with fewer complications and a faster recovery.
According to a new study from researchers at the University of Oxford, partial knee replacement is being used less than it could be.
Joint replacements are common and highly successful operations that relieve pain and improve mobility for many patients.
Partial knee replacement is a procedure where only the damaged part of the knee joint is replaced. It is less invasive than a total knee replacement, meaning the patient has a faster recovery and lower risk of complications following the operation.
Although about half of patients who need a knee replacement are suitable for a partial replacement, less than 10% have the procedure, according to the National Joint Registry (NJR). This study from Oxford University's Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences aimed to reduce uncertainty around which type of knee replacement to use.
Using data from the NJR, which routinely collates detailed information on all joint replacement operations in England, Wales, Northern Ireland and the Isle of Man, the researchers compared the costs and health outcomes of partial and total knee replacement.
Their analysis revealed that the use of partial replacement varies greatly between different surgeons. Partial replacements carried out by surgeons using them for a small proportion of knee replacements provide worse outcomes than total replacements.
But partial replacements carried out by surgeons using them for a higher proportion of knee replacements provide better outcomes and are cheaper than total replacements.
The study results – published in BMJ Open – suggest that in order to realise potential health benefits for patients, surgeons need to increase the proportion of partial replacements they carry out.
Co-lead researcher Professor David Murray said: “If surgeons aim to use partial knees in a quarter or more of their knee replacements, this will substantially improve the results of knee replacement and will save money. In addition, more partial knee replacements will be done and more patients will benefit from this procedure.”
The authors cautioned that further research is needed to optimise the use partial knee replacement, which may depend on the type of implants used. Also, although partial knee replacements appear to be better and cheaper for patients over 60, the long-term benefits for younger patients are less clear.
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