HOW LONG DOES A KNEE REPLACEMENT LAST? A SYSTEMATIC REVIEW AND META-ANALYSIS OF CASE SERIES AND NATIONAL REGISTRY REPORTS WITH MORE THAN 15 YEARS OF FOLLOW-UP

Review written by Dr Sarah Haag info

BACKGROUND & OBJECTIVE

Knee replacements are a very common treatment option for end-stage osteoarthritis of the knee. While knee replacements are very common, there has not previously been a systematic review of national registries to determine how long knee replacements actually last.

METHODS

The systematic review and meta-analysis followed a predefined protocol registered with PROSPERO (a database of systematic review protocols) and adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Case series and cohort studies that reported survival outcomes for knee replacements, published between commencement of each database and July 21, 2018 were included.

Studies were included regardless of the type of knee replacement, as long as the mean or median follow-up was more than 15 years. The make and model of the replacement was thought to be fundamental to the outcome of the surgery, so aggregated data combining constructs was not included. The abstracts were screened by three reviewers, using the web application Rayyan, and in cases of disagreement were included for full review. Study quality was assessed using the non-summative four-point system.

RESULTS

The search resulted in 30 journal articles and 33 case reports. The quality assessment did reveal that in general the quality of published case series is low. The reports and series included both total knee replacement (TKR) and unicondylar knee

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