Partial knee replacement could save the NHS £30m

The economic benefit of using partial knee replacements (PKR) could save the NHS approximately £30 million per annum based on an increase of 31 per cent usage.

New research funded by NIHR has claimed that PKR as good as total knee replacements (TKR), whilst being more cost effective. In fact, researchers at the University of Oxford argue that, over five years PKR has similar, if not a slightly better clinical outcome than TKR.

Only nine per cent of joint replacements are currently PKR, although it is thought that around 40 per cent of patients could be suitable candidates.

Over 300,000 knee replacements are performed in the UK each year, mainly for osteoarthritis.  Surgeons and patients face a choice of which type of operation to perform or undergo for medial compartment (one area in the joint) arthritis.

TKR replaces all parts of the joint whereas a PKR replaces only the diseased area and retains as much soft tissue as possible. TKR is fully established and used most often whereas PKR is less common and has been in widespread use for a shorter period.

David Beard, director of the Surgical Interventional Research Unit at the University of Oxford, said: “Despite many previous studies and considerable data, we have never had a sufficiently large randomised clinical trial to answer this important question. TOPKAT has now definitively shown us that both operations provide benefit and are worthwhile but, given the option, PKR is probably the implant of choice – providing sufficient expertise exists to implant it.

“An important caveat is that the surgeries in the trial were performed by well trained, experienced surgeons in both groups. If any recommendation to increase the use of PKR is made it will have to be accompanied by provision of adequate training and expertise for surgeons undertaking the technically more demanding PKR procedure.”