The Knee Care Press


Could PKR save the health service millions?

A News Medical review of the TOPKAT (Total or Partial Knee Arthroplasty Trial), published in the Lancet suggests they could1

According to News Medical, a 31% increase in PKR usage could save the health service about £30 million per year.1 This is based on the observation that currently PKR represents around 9% of all knee replacements while it is thought that more than 40% of patients receiving a knee replacement could be suitable candidates for PKR. 1

This randomised clinical trial funded by the National Institute for Health Research (NIHR) shows that over a five-year period PKR provides substantial cost-savings compared to TKR, while delivering similar or slightly better clinical outcomes. 2

As quoted by News Medical, Chief investigator Professor David Beard, Rosetrees/Royal College of Surgeons 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.”

Interestingly, the News Medical review also observed that the revision rate for PKR was found to be identical to that of TKR at 4%. 1 They noted that “these findings contrast with previous research based on national registries, which showed PKR to have higher revision rates.” 1

Similar to previous reports, they also recognised that more patients in the PKR group indicated that they would have the operation again compared to those in the TKR group 1.

  2. Beard DJ, Davies LJ, Cook JA, MacLennan G, Price A, Kent S, Hudson J, Carr A, Leal J, Campbell H, Fitzpatrick R, Arden N, Murray D, Campbell MK; TOPKAT Study Group. The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial. Lancet. 2019: 31; 394(10200): 746-756. doi: 10.1016/S0140-6736(19)31281-4. Find the source here.

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