Abstract
Purpose
To review the Five year survivorship of Kinnemax TKA performed at the NHS Treatment Cantre, Weston-Super-Mare (WSM), and compare it to a similar cohort from our institution.
Introduction
As part of the government's initiative to reduce waiting times for major joint surgery in Wales, the Cardiff and Vale NHS Trust (CAVOC) sent 224 patients (258 knees) to the NHS Treatment Centre in Weston-Super-Mare (WSM) for total knee arthroplasty. Controversy remains as to the unexpectedly high revision rates previously seen.
Method
Between April 2004 and January 2006, 224 patients (258 TKAs) were performed at WSM. 90% have been followed up to five years. The WSM Cohort was compared to a similar cohort of 260 consecutive TKAs from CAVOC over a similar time period (2004/5) performed by a number of surgeons. Oxford Knee Score, EQ5D, VAS for pain, re-operation and overall satisfaction were obtained. Statistical testing was performed with chi-squared tests using SPSS v16.0 (a=0.05).
Results
Mean age in years at date of operation was 68 (36-85) from WSM and 70 (41 to 87) fromCAVOC. The 5 year cumulative survival rate using ‘revision any cause’ as the endpoint, was 79.9% (95% CI 72.46 to 85.9) in the WSM cohort and 96.4% (95%CI 94.1 to 99.1) in the CAVOC cohort. The relative risk for revision at the ISTC as opposed to the referring centre was 3.76 (p<0.001). The mean Oxford Knee Score was 27.5 (range 2-48) for the WSM cohort. The average, non-revised, oxford knee score for the WSM cohort lower than expected at 29. This is lower than other published series of primary TKA.
Conclusion
This is the first published five year survivorship for total knee arthroplasty performed at a first generation ISTC in the UK. Revision rates, functional outcomes, and overall health status results are below expected when compared to a similar cohort from a standard NHS Orthopaedic Unit.
