YKC’s Nick London reveals research that shows partial knee replacements are now suitable for “a majority of patients”.
Partial knee replacements aren’t new. My Yorkshire Knee Clinic colleagues and I have been performing them successfully for years, but each improvement in implant technology needs to be accompanied by ongoing research to assess how well that implant performs. It’s not just a matter of knowing the implant is effective – although that’s certainly a major factor – it’s also about understanding how long it remains effective for, how patients feel about their knee replacement, and how many patients can benefit from it.
That is the goal of a significant study by myself, my YKC colleague Dave Duffy and others at Harrogate District Hospital and The Duchy Hospital in Harrogate, supported by the European Knee Society. Our study involved partial knee replacements in 229 consecutive patients who each received the Persona Partial Knee (PPK) implant. ‘Consecutive’ in this case means we looked at every patient receiving the PPK in 2017 and since without further selection or sifting.
We looked at the outcomes of surgery (that is, how well the knees are performing) and patient satisfaction as a group and with certain specific subsets of the group. In particular, we looked at the following:
- ACL-deficient patients – we wanted to see how patients without a functioning anterior cruciate ligament fared with a fixed bearing partial knee replacement
- Patients with kneecap arthritis – in the past, some knee surgeons have only performed total knee replacements on patients with kneecap wear. We wanted to see how partial knee replacements performed in such patients
- Age – we wanted to understand the benefits of partial (as opposed to total) knee replacements in the very young (under-50) or elderly
We’ve recently presented findings from our reviews at one and two years post-replacement. You can find more about each study subgroup and the (extremely positive) results by following the above links.
High satisfaction, low revision
The overriding message from our study and from other research reported previously is that, in my opinion, partial knee replacement is suitable for a majority of patients whose symptoms are sufficient for them to be offered some form of knee replacement surgery.
Our patients expressed very high levels of satisfaction (96.8% at two years, compared with satisfaction scores around 80% for total knee replacements). Of the 229 patients in the study, just two (0.87%) have required revision, which is much lower than we would expect from other similar implants. Our data have now been published on the National Joint Registry, which shows the Persona Partial Knee as having the lowest revision rate at three years of any implant, partial or total.
More patients suited to partial knee replacements
These are important findings because, as with any new procedure, you tend to start with a fairly narrowly defined set of criteria for suitable patients and then, as the body of data grows, you can expand those criteria. That is the effect of this research, which means many more patients should be able to benefit from the numerous clear advantages that have made the PPK the gold standard for knee replacement.
From January 2022 we’ll be starting to receive patient outcome data for our five-year follow up and we’re confident from our experiences over the past 20 years that we’ll continue to see very high patient satisfaction scores and functional outcomes combined with low revision rates.
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