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.

A new study by researchers at NDORMS, University of Oxford now published in Osteoarthritis and Cartilage found that the average lifetime risk of needing further surgery following knee and hip replacement – revision surgery – was around 5% after knee replacement and 8% after hip replacement, with neither body mass index (BMI, combining an individual's height and weight) or smoking having any meaningful effect on these risks.

The team, which included senior researchers in epidemiology, health economics and orthopaedic surgery, used routinely-collected hospital and primary care data from patients who had a knee replacement or a hip replacement in England, assessing over 10,000 patients for each procedure.

With healthcare budgets stretched, the provision of knee and hip replacements has come under increased pressure in the NHS. One result is that access to these surgeries has been restricted, and a number of clinical commissioning groups (CCGs) are currently limiting access based on patient's BMI and smoking status. In 2015, 22% of CCGs had a mandatory policy for knee and replacement regarding BMI, varying their cut-offs from a BMI of 30 to 40, and 4% of CCGs had mandatory policies requiring smoking cessation.

"Our findings, along with those from previous research, suggest that there is little evidence to support the rationing of knee and hip replacement based on individuals' BMI or smoking" said Ed Burn, DPhil student at the University of Oxford. "While there are many benefits from losing weight if overweight and stopping smoking, there seems to be little justification in limiting access to knee and hip replacement until such changes are made".

Previous research had already shown that BMI and smoking have little effect on patient reported outcomes after knee and hip replacement, but may be associated with a slight increase in the risk of post-operative complications.

Revision procedures are where implant components are removed, added, or exchanged. Revisions are an enduring risk, are more costly than primary procedures, and are associated with reductions in patient quality of life.

Funder

National Institute for Health and Care Research logo

Similar stories

Matthew Costa elected Fellow of Academy of Medical Sciences

Matthew Costa, Professor of Orthopaedic Trauma Surgery at NDORMS, has been elected a Fellow of the Academy of Medical Sciences.

COVID-19’s high blood clot risk

A recent study of patient health records found that around 1 in 100 people with COVID-19 had a venal or arterial thrombosis, with rates higher still among males, and particularly for those hospitalised.

REF 2021 results for medical research in Oxford

Today the UK Funding Bodies have published the outcomes of the recent national research assessment exercise, the Research Excellence Framework (REF) 2021.

Nurses' Day 2022

Today marks Nurses' Day 2022. This year's theme is #BestofNursing, so we chatted to some of our amazing Research Nurses about what the Best of Nursing means to them.

Rethinking pain management after injury

NDORMS researchers are to study whether a pain management treatment using cognitive behavioural therapy will improve recovery for people who have had a major leg injury.

Breakthrough in treatment for Dupuytren’s disease

Injection of the anti-TNF drug adalimumab into Dupuytren’s disease nodules is effective in reducing nodule hardness and nodule size.