Our Summary

This study compares the cost and effectiveness of two types of knee replacement surgeries: unicompartmental knee replacement (UKR) and total knee replacement (TKR). UKR is a less invasive procedure where only the part of the knee damaged by osteoarthritis is replaced.

The study used data from the National Joint Registry for England and Wales to compare patients who had either of these two surgeries. The main measures of success were the quality and length of life after surgery and the cost to the healthcare system.

The results showed that UKR generally led to better health outcomes and lower costs than TKR for all age and gender groups. However, this varied depending on how often surgeons performed UKR. Those who did this type of surgery more often achieved better results and saved more money than those who did it less often.

So, the findings suggest that UKR can be a better and cheaper option than TKR. But to get these benefits, surgeons need to do this type of surgery regularly. Surgeons who don’t do UKR often might need to consider doing it more to get the best results for their patients.

FAQs

  1. What are the two types of knee replacement surgeries compared in the study?
  2. What were the main measures of success in the study comparing UKR and TKR?
  3. According to the study, what factor affects the success and cost-effectiveness of UKR?

Doctor’s Tip

A doctor might recommend to a patient considering knee replacement surgery to discuss the option of unicompartmental knee replacement (UKR) with their surgeon. They could explain that UKR is generally a less invasive procedure with better health outcomes and lower costs compared to total knee replacement (TKR). It may be beneficial for the patient to seek out a surgeon who performs UKR regularly to ensure the best results.

Suitable For

Patients who are typically recommended for knee replacement surgery are those who have severe knee pain and stiffness that limits their daily activities, have not found relief from other treatments such as medications or physical therapy, and have knee damage or deformity due to osteoarthritis, rheumatoid arthritis, or other conditions. Patients who are younger and have less severe knee damage may be good candidates for unicompartmental knee replacement, while those with more extensive knee damage may benefit more from total knee replacement. Ultimately, the decision to undergo knee replacement surgery should be made in consultation with a healthcare provider based on the individual’s specific condition and needs.

Timeline

Before knee replacement surgery, a patient typically experiences chronic knee pain, swelling, stiffness, and difficulty performing daily activities. They may have tried conservative treatments such as physical therapy, medications, injections, and weight loss without success.

After knee replacement surgery, patients typically go through a recovery process that includes physical therapy, pain management, and gradually increasing their activity levels. It may take several weeks to months to fully recover and regain strength and function in the knee. Many patients report significant improvement in pain and mobility after surgery, allowing them to return to their normal activities and enjoy a better quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about knee replacement include:

  1. What are the differences between unicompartmental knee replacement (UKR) and total knee replacement (TKR)?
  2. Which type of knee replacement surgery do you recommend for me and why?
  3. How often do you perform UKR surgeries compared to TKR surgeries?
  4. What are the potential risks and complications associated with each type of surgery?
  5. What is the expected recovery time and rehabilitation process for each type of surgery?
  6. What are the long-term outcomes and success rates for UKR compared to TKR?
  7. How will my age and gender impact the decision between UKR and TKR for me?
  8. What are the costs associated with each type of surgery, including potential additional costs for follow-up care?
  9. Are there any alternative treatments or therapies that I should consider before opting for knee replacement surgery?
  10. Can you provide me with information on your experience and success rates with performing UKR surgeries?

Reference

Authors: Burn E, Liddle AD, Hamilton TW, Judge A, Pandit HG, Murray DW, Pinedo-Villanueva R. Journal: BMJ Open. 2018 Apr 29;8(4):e020977. doi: 10.1136/bmjopen-2017-020977. PMID: 29706598