An evaluation of knee arthroplasty fixation

  • Research type

    Research Study

  • Full title

    An evaluation of knee arthroplasty fixation in an evolving challenging population

  • IRAS ID

    260499

  • Contact name

    Hasan Mohammad

  • Contact email

    hasanmohammad@doctors.org.uk

  • Sponsor organisation

    University of Oxford, Clinical Trials and Research Governance

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Over 100,000 knee replacements are performed annually in the United Kingdom with this number expected to increase six times by 2030. Up to one fifth of patients experience persistent pain and are unsatisfied with their knee replacement. The number of patients requiring repeat surgery has almost doubled in recent years. Approximately one million records will be accessed.

    Knee replacements can be secured in place using cement or without cement (uncemented). Most surgeons currently use cement although some do not, with no overall opinion on which is better. There are concerns that cement may not last a patient’s lifetime with studies showing younger and overweight patients do worse with cemented knee replacements. Furthermore, cement setting during the operation gives off considerable heat which may contribute to long term pain. Uncemented knee replacements have advantages over cemented, including reduced surgery times, blood loss and infection risk. This reduces the chances of serious illness, disability and death.

    We will analyse data routinely collected for all knee replacements from the National Joint Registry and patient data routinely collected from hospitals (Hospital Episode of Statistics). We intend to complete a full comparison of cemented and uncemented knee replacements by comparing; 1) how long each replacement type lasts, numbers of deaths after surgery and patient’s pain and function, 2) different replacement designs and patient groups. 3) how knee replacements fail and 4) cost effectiveness.

    Our work will inform whether cement should or not be used overall and then for different replacement designs and patient groups. This will help provide more tailored patient care, potentially reduce repeat surgeries and improve outcomes, whilst empowering patients to make more informed decisions. The results of this work will also help guide healthcare providers into which treatment is the most medically and cost-effective.

  • REC name

    South Central - Oxford B Research Ethics Committee

  • REC reference

    19/SC/0292

  • Date of REC Opinion

    18 Jun 2019

  • REC opinion

    Favourable Opinion