Partial knee replacement – the latest data on how long yours will last

The latest findings of the TOPKAT trial offer reassurance for patients, surgeons and health authorities about the long-term effectiveness of partial knee replacement. YKC’s Dave Duffy explains.

In knee replacement, several things really matter to patients. Pain reduction is one. Mobility and the ability to return to activities osteoarthritis may have forced you to curtail is another. And then there’s the question of longevity, or as patients usually put it: “How long will my knee replacement last?”

This last question has always presented a bit of an issue for knee surgeons – especially when comparing partial knee replacement with total knee replacement – because we want to give accurate, evidence-based information. Total knee replacement arrived first and proved itself in high volumes years ago. In terms of the volume of patient data, modern partial knee replacements have been playing catch-up.

Thankfully, the catch-up is well underway thanks to TOPKAT, the Oxford-led Total or Partial Knee Arthroplasty Trial which has followed knee replacement patients since their operations between 2010 and 2013.

The trial drew data from 27 UK NHS hospitals and knee replacements by myself and my Yorkshire Knee Clinic colleague Nick London formed part of the study.

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Ten years of data

Five years ago, TOPKAT reported its five year results in The Lancet. As expected, total and partial replacements showed similar clinical outcomes, reoperation rates, and revision rates, but cost effectiveness was in favour of partial.

That was extremely encouraging, but patients want more than five years of results. Happily, TOPKAT has now published its ten-year update and the outcomes remain the same, while cost benefit and risk are lower in respect of partial knee replacements.

Partial or total?

We’ve written extensively about this in the past, but TOPKAT confirms what we have long believed. Partial knee replacement is cheaper for the NHS and the risk of infection is less, while both partial and total implants perform equally well at ten years.

Our position, just to add extra weight to the partial vs total debate, is that function is better with a partial knee replacement, your hospital stay is typically shorter and recovery is usually quicker. And a partial replacement still gives you the option of a total knee replacement in the future, potentially giving you decades of implant-assisted mobility.

>  Discover more about partial or total knee replacements

Partial knee replacement; partial availability

All of this explains why partial knee replacement is being offered to more patients. TOPKAT’s data provides the evidence and reassurance patients, surgeons and health authorities seek. Five years ago, partial knees were rarely offered to patients who were suitable for it – and although opinion varies, the broad consensus is that it’s suitable for 30% – 40% of patients. This may rise to more than 50% in the hands of an experienced surgeon.

Yet we are still facing a lack of experienced surgeons and rates of partial knee replacements can vary significantly across the country. It is through trials like TOPKAT that we lay the foundations on which we can build greater surgeon training and ensure every part of the country can access partial knee replacement.

Exploring your knee replacement options? Please contact us, or phone us on 03453 052 579.

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>  Discover more about partial or total knee replacements
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