Where are all the partial knee replacements?
Partial knee replacements typically mean less risk, better results and faster recovery. So why are up to 50,000 patients missing out each year?
Partial knee (or uni-compartmental) replacements aren’t suitable for everyone. Your knee has three compartments and where the surface of the bone is worn away in two or more of them you’ll need a total knee replacement. But where the damage is confined to one compartment (typically the inner one) a partial knee replacement is often the preferable treatment.
Usually, a partial replacement means your hospital stay is shorter and recovery is faster. The incision is smaller, reducing the potential for post-op infection and clots in the leg by a third when compared to a full knee replacement. As a final bonus, the procedure is cheaper than a total replacement – which is good news for everyone and especially the perpetually cash-strapped NHS.
So where are all the partial knee replacement operations?
In a study by Oxford University reported in virtually every daily newspaper including the Telegraph and Daily Mail, of the 100,000 knee replacements carried out in 2016, fewer than one in 10 were partial knee replacements. According to the study, which analysed data from the National Joint Registry, as many as 50% of patients could have been suitable for partial replacements.
There’s one key finding from the study that the national press has largely missed which goes a long way towards explaining the reasons for the shortfall. In order to realise the full benefits of a partial knee replacement, your knee surgeon should be performing a lot of them. Without that experience, the report inferred, the benefits diminish.
All the knee specialists at Yorkshire Knee Clinic are what are known as ‘high volume’ knee surgeons and we all comfortably meet the report’s criteria of experience. So why might your knee surgeon not be a high volume practitioner?
In part, the answer lies in surgical training, because only 9% of replacements are currently uni-compartmental, it’s possible to go through orthopaedic training and never see one.
To improve the stats we need to see more knee surgeons willing to embrace the learning curve required to perform this established procedure. Some don’t want to do that.
Yet all the research suggests that we won’t be able to achieve the improved patient and cost benefits that partial replacements offer unless we have more knee surgeons doing more partial knee procedures more often.
If you are experiencing knee pain, talk to the knee surgeons at Yorkshire Knee Clinic.