Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Opioid use and additional post-operative complications have been shown to be reduced when partial knee replacement is used over surgery where the whole of the joint is replaced.

Person holding their knee in pain. © Shutterstock

A new study published in Lancet Rheumatology reports the results from a multinational database study on knee replacement. The largest study of its kind to date, it assessed data from over 250,000 individuals in the US and UK who had undergone either partial (unicompartmental) or total knee replacement to compare the clinical outcomes for patients. Partial knee replacements were shown to reduce the risk of complications after surgery, in particular venous thromboembolism, and a reduction in the use of potent painkillers (opioids), possibly indicating a reduced risk of persistent pain after surgery. Total knee replacement was however associated with a lower risk of revision procedures.

The study builds on the Total or Partial Knee Arthroplasty Trial (TOPKAT), led by researchers at the University of Oxford, which found that after 5 years, partial knee replacement showed similar, if not better, outcomes than total replacement. This new study explored whether those results translate into effectiveness in real-world settings and investigated safety outcomes that were too rare to study in detail in TOPKAT due to fewer patient numbers.

Researchers belonging to the global Observational Health Data Sciences and Informatics (OHDSI) network, and the IMI European Health Data & Evidence Network (EHDEN), came together with in Oxford in December 2018 to plan and perform the study. The analyses were designed and conducted in a week-long "study-a-thon". This collaborative endeavour was facilitated by the use of previously mapped real-world data and the availability of previously validated analytical tools.

"We brought together experts with knowledge of the data sources, methodological approaches, or the clinical area," said Ed Burn, Research Associate in real world health economics at NDORMS at the University of Oxford, and one of the joint first authors of the paper, "with the application of a common data model and open-source tools allowing us to quickly design a robust study and run it on both primary care data from the UK and insurance claims data from the US."

Professor Daniel Prieto-Alhambra, one of the senior authors of the paper, is a workpackage lead of the European Health Data & Evidence Network (EHDEN), an EU Innovative Medicines Initiative (IMI2) project. "EHDEN will stimulate the further development of the research ecosystem that this study utilised in Europe," explained Professor Prieto-Alhambra. "By doing so, EHDEN will increase our ability to generate reliable, reproducible and top-quality evidence from real-world data in Europe and globally."

"This is exactly what EHDEN is setting out to do in terms of good quality evidence that informs clinical practice across many domains, but importantly it also demonstrates the efficacy of our collaboration with OHDSI," said Associate Professor Rijnbeek, Academic Coordinator of EHDEN.

The findings of this study will help to inform shared decision making for individuals eligible for knee replacement surgery, and the approach used for this study provides a template for future analyses of real-world data.

A video presentation on the project and the study-a-thon

Similar stories

COVID-19 vaccines shown to reduce infection by 90% in nursing homes

A new collaborative study between the Catalan Institute of Health, the Public Health Secreatariat of Catalonia, and the Centre for Statistics in Medicine, NDORMS, at the University of Oxford have confirmed that COVID-19 vaccines greatly reduce infections, hospitalisations and mortality for up to 6 months.

The Kennedy Institute completes its roof extension

Building work at the Kennedy Institute of Rheumatology has finished, providing a new third floor that houses additional meeting and collaboration space for data science and offices for the management of clinical trials.

Unlocking the secrets of the microbiome

Jethro Johnson, Deputy Director of the Oxford Centre for Microbiome Research explains how the centre is building a research community to understand the microbiome and harness its power to promote health and prevent disease.

Into the future: watching biology unfold

As part of the University of Oxford’s mission to provide its researchers with the newest state-of-the-art optical imaging equipment and as part of a strategic partnership with the Kennedy Institute of Rheumatology (KIR), the Institute of Developmental and Regenerative Medicine (IDRM), and Carl Zeiss AG (ZEISS), ZEISS has installed a ZEISS Lattice Lightsheet 7 microscope at the KIR.

New Botnar Research Institute Director starts today

Professor Jonathan Rees begins his new role as Director of the Botnar Research Institute today, taking over from Professor Andrew Carr.

Patient and public involvement in Rheumatology research – embracing the wave of change

On launching the new OPEN ARMS PPI group in Oxford, Dr. Laura Coates explored the patient and public involvement (PPI) models of three academic centres in the UK to show how it benefits researchers, clinicians, and patients alike.