Adverse outcomes after total and unicompartmental knee replacement in 101 330 matched patients: a study of data from the National Joint Registry for England and Wales

Abstract

Royal College of Surgeons of England and Arthritis Research UK.

Evidence-Based Indications for Mobile-Bearing Unicompartmental Knee Arthroplasty in a Consecutive Cohort of Thousand Knees

“…Unicompartmental knee replacement (UKR) has significant patient benefits over total knee 36 replacement (TKR) including improved functional outcomes and significantly lower morbidity 37 and mortality [1]. Despite the benefits of UKR it remains relatively underutilised and this in part 38 is due to controversies in the indications.…”

Patient safety after partial and total knee replacement

“…2 Hyperhomocysteinaemia impairs arterial fl ow and has been associated with cardiovascular disease. 3 The authors report that nitrous oxide did not increase year immediately on operative costs alone, 18,21 and, on the basis of these two papers, there would be 170 fewer postoperative deaths annually, and many hundreds of fewer strokes, myocardial infarctions, and infections.…”

“…1 The human cost of this expensive surgery is addressed in two articles in The Lancet 2,3 that question conclusions from the NJR, with major consequences for patient safety and the knee replacement industry.…”

“…Implant-related complications resulting in operations occur later and were substantially more common after UKR (subhazard ratio [SHR] 2·12, 95% CI 1·99-2·26) at 8 years. 3 These problems, which were mainly loosening and implant failure, were usually treated by a primary TKR. When the same problems of loosening or implant failure resulted in reoperation after TKR, they were often treated by larger so-called revision devices involving stems and augments.…”

The frequency of spinal stenosis in patients who underwent total knee arthroplasty

“…Patients with advanced osteoarthritis can be treated with total knee arthroplasty which significantly improves the pain and function of patients [5].…”