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Lookup NU author(s): Paul Baker, Dr Simon Jameson, Dr Peter Avery, Michael Reed, Professor Paul Gregg, Professor David Deehan
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Following arthroplasty of the knee, the patient's perception of improvement in symptoms is fundamental to the assessment of outcome. Better clinical outcome may offset the inferior survival observed for some types of implant. By examining linked National Joint Registry (NJR) and patient-reported outcome measures (PROMs) data, we aimed to compare PROMs collected at a minimum of six months post-operatively for total (TKR: n = 23 393) and unicondylar knee replacements (UKR: n = 505). Improvements in knee-specific (Oxford knee score, OKS) and generic (EuroQol, EQ-5D) scores were compared and adjusted for case-mix differences using multiple regression. Whereas the improvements in the OKS and EQ-5D were significantly greater for TKR than for UKR, once adjustments were made for case-mix differences and pre-operative score, the improvements in the two scores were not significantly different. The adjusted mean differences in the improvement of OKS and EQ-5D were 0.0 (95% confidence interval (CI) -0.9 to 0.9; p = 0.96) and 0.009 (95% CI -0.034 to 0.015; p = 0.37), respectively. We found no difference in the improvement of either knee-specific or general health outcomes between TKR and UKR in a large cohort of registry patients. With concerns about significantly higher revision rates for UKR observed in worldwide registries, we question the widespread use of an arthroplasty that does not confer a significant benefit in clinical outcome.
Author(s): Baker PN, Petheram T, Jameson SS, Avery PJ, Reed MR, Gregg PJ, Deehan DJ
Publication type: Article
Publication status: Published
Journal: Journal of Bone and Joint Surgery: British Volume
Year: 2012
Volume: 94B
Issue: 7
Pages: 919-927
Print publication date: 01/07/2012
ISSN (print): 0301-620X
ISSN (electronic): 2044-5377
Publisher: British Editorial Society of Bone and Joint Surgery
URL: http://dx.doi.org/10.1302/0301-620X.94B7.28436
DOI: 10.1302/0301-620X.94B7.28436
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