The recently published UK National Institute of Health and Care Excellence (NICE) quality statement on joint replacement reports that in adults with isolated medial compartmental osteoarthritis who require a knee replacement, a choice between partial and total knee replacement should be offered, if clinical and radiological evaluation demonstrates that both are appropriate treatment options. Furthermore, talking through the risks and benefits help the patient to choose which procedure is best for them, based on their personal situation and preferences.
Measures to evaluate the quality of care or service provision could include:
- Proof of local procedures to assist in a discussion of the risks and benefits of both treatment types.
- Proof of service specifications to ensure that both procedures are available.
- Proportion of primary knee replacements that are partial knee replacements.
What does the quality statement mean for different groups?
Service providers need to verify that patients with isolated medial compartmental arthritis that require a knee replacement are given a choice between a partial or total knee if clinical and radiographic analysis shows that both are suitable treatment options. This decision should be made following a discussion on the risks and benefits of both and based on the personal circumstances and preferences of the individual.
Healthcare professionals should allow time to talk through the risks and benefits of both treatment options. Furthermore, healthcare professionals should ensure that the patient receives the procedure that they have chosen.
Commissioners should ensure that they commission services that offer partial and total knee replacement and provide patients with the opportunity to discuss the benefits and risks of both procedures.
Adults who have isolated medial compartmental osteoarthritis who require a knee replacement and could have a partial or total knee should discuss the risks and benefits of both procedures in addition to their personal circumstances and preferences with the orthopaedic team.