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Comparison of patient-reported outcome measures following total and unicondylar knee replacement

Lookup NU author(s): Paul Baker, Dr Simon Jameson, Dr Peter Avery, Michael Reed, Professor Paul Gregg, Professor David Deehan

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Abstract

Following arthroplasty of the knee, the patient's perception of improvement in symptoms is fundamental to the assessment of outcome. Better clinical outcome may offset the inferior survival observed for some types of implant. By examining linked National Joint Registry (NJR) and patient-reported outcome measures (PROMs) data, we aimed to compare PROMs collected at a minimum of six months post-operatively for total (TKR: n = 23 393) and unicondylar knee replacements (UKR: n = 505). Improvements in knee-specific (Oxford knee score, OKS) and generic (EuroQol, EQ-5D) scores were compared and adjusted for case-mix differences using multiple regression. Whereas the improvements in the OKS and EQ-5D were significantly greater for TKR than for UKR, once adjustments were made for case-mix differences and pre-operative score, the improvements in the two scores were not significantly different. The adjusted mean differences in the improvement of OKS and EQ-5D were 0.0 (95% confidence interval (CI) -0.9 to 0.9; p = 0.96) and 0.009 (95% CI -0.034 to 0.015; p = 0.37), respectively. We found no difference in the improvement of either knee-specific or general health outcomes between TKR and UKR in a large cohort of registry patients. With concerns about significantly higher revision rates for UKR observed in worldwide registries, we question the widespread use of an arthroplasty that does not confer a significant benefit in clinical outcome.


Publication metadata

Author(s): Baker PN, Petheram T, Jameson SS, Avery PJ, Reed MR, Gregg PJ, Deehan DJ

Publication type: Article

Publication status: Published

Journal: Journal of Bone and Joint Surgery: British Volume

Year: 2012

Volume: 94B

Issue: 7

Pages: 919-927

Print publication date: 01/07/2012

ISSN (print): 0301-620X

ISSN (electronic): 2044-5377

Publisher: British Editorial Society of Bone and Joint Surgery

URL: http://dx.doi.org/10.1302/0301-620X.94B7.28436

DOI: 10.1302/0301-620X.94B7.28436


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