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The Knee Care Press

Weekly

NICE recommends
all hospitals to provide PKR


Suitable patients are to be offered an informed choice of PKR or TKR


How many patients with isolated medial compartmental osteoarthritis would favour partial over total knee replacement if all of them were offered the choice?

We don’t know either; but we do know that the UK’s National Institute for Health and Care Excellence (NICE) are recommending that all patients with isolated medial compartment osteoarthritis be offered an informed choice of PKR or TKR!1

There are advantages and disadvantages to both procedures.

  • NICE recognised that recovery from PKR is faster, with shorter length of hospital stay, and less pain during recovery.1
  • They also noted that rare complications like infections, blood clots, hearts attacks and stroke are lower after PKR than TKR.1
  • On the flip-side, NICE acknowledged some registry evidence that PKR revision rates are higher than for TKR.1

According to NICE, patients will perceive these relative risks and benefits differently according to their personal circumstances and priorities. Hence they recommend that suitable patients are offered an informed choice of PKR or TKR.

They anticipate that this will increase the number of PKR surgeries and due to the evidence that PKR are more cost-effective than TKR, will also result in cost savings.

  1. Joint replacement (primary): hip, knee and shoulder. NICE guideline [NG157]. Published date: 04 June 2020. 1.7 Procedures for primary elective knee replacement. NICE guideline [NG157] Published date: 04 June 2020.

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