Cochrane tourniquet TKA reviewThe Cochrane database of systematic reviews 2020
Tourniquet use for knee replacement surgery.
Tourniquet use was associated with a higher risk of serious adverse events (such as venous thromboembolism and infection) and slightly worse early postoperative pain, with little or no functional benefit.
Systematic review / meta-analysisManagementKnee arthroplasty
TOPKATLancet (London, England) 2019
The clinical and cost-effectiveness of total versus partial knee replacement in patients with medial compartment osteoarthritis (TOPKAT): 5-year outcomes of a randomised controlled trial.
There was no significant difference in Oxford Knee Score at 5 years, with similar reoperation and complication rates; partial knee replacement was more cost-effective and showed small advantages in some secondary measures.
Randomised trialManagementKnee arthroplasty
Robotic-arm assisted TKA (Kayani)The bone & joint journal 2018
Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study.
Robotic TKA was associated with significantly less early postoperative pain and analgesia requirement, faster attainment of straight leg raise and range of motion, and shorter hospital stay.
Cohort studyManagementKnee arthroplasty
Skou TKR vs non-surgical RCTThe New England journal of medicine 2015
A Randomized, Controlled Trial of Total Knee Replacement.
TKR plus non-surgical treatment produced significantly greater improvement in pain, function and quality of life at 12 months, but with more serious adverse events; most in the non-surgical group improved and many had not undergone TKR by 1 year.
Randomised trialManagementKnee arthroplasty
NJR UKA vs TKA matched study (Liddle)Lancet (London, England) 2014
Adverse outcomes after total and unicompartmental knee replacement in 101,330 matched patients: a study of data from the National Joint Registry for England and Wales.
UKA had significantly lower early mortality, fewer thromboembolic events, myocardial infarctions and strokes, shorter stay and fewer readmissions, but significantly higher revision and reoperation rates.
Registry studyPrognosisKnee arthroplasty
Kinematic vs mechanical alignment RCT (Dossett)The bone & joint journal 2014
A randomised controlled trial of kinematically and mechanically aligned total knee replacements: two-year clinical results.
Kinematically aligned knees had significantly better pain relief, Oxford, WOMAC and Knee Society scores and greater flexion at 2 years than mechanically aligned knees.
Randomised trialManagementKnee arthroplasty
Long-term pain after TKR (Beswick)BMJ open 2012
What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients.
Roughly 10-34% of patients after TKR reported unfavourable long-term pain, compared with about 7-23% after THR, a higher proportion after knee than hip replacement.
Systematic review / meta-analysisPrognosisKnee arthroplasty
KAT patellar resurfacingThe Journal of bone and joint surgery. American volume 2011
Patellar resurfacing in total knee replacement: five-year clinical and economic results of a large randomized controlled trial.
There was no significant difference in Oxford Knee Score or any other outcome at 5 years, including reoperation and later patella-related surgery, and total healthcare costs did not differ between resurfacing and non-resurfacing.
Randomised trialManagementKnee arthroplasty
Mechanical axis and TKA survival (Parratte)The Journal of bone and joint surgery. American volume 2010
Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements.
There was no significant difference in 15-year survival between knees aligned within the neutral range and outliers.
Cohort studyPrognosisKnee arthroplasty