Patellar resurfacing in total knee replacement: 20-year clinical and economic results of a large multicentre, randomised controlled trial in the UK.

This study has been identified as potentially high impact. OE's AI-driven High Impact metric estimates the influence a paper is likely to have by integrating signals from both the journal in which it is published and the scientific content of the article itself. Developed using state-of-the-art natural language processing, the OE High Impact model more accurately predicts a study's future citation performance than journal impact factor alone. This enables earlier recognition of clinically meaningful research and helps readers focus on articles most likely to shape future practice.

Study Summary

1715 patients undergoing primary total knee replacement (TKR) were randomized to receive patellar resurfacing or no patellar resurfacing. The primary clinical outcome was the Oxford Knee Score (OKS), while the primary economic outcome was incremental cost per quality-adjusted life-year gained. Secondary outcomes included the 12-Item Short Form Health Survey (SF-12), European Quality of Life 5-Dimensions 3-Levels score (EQ-5D-3L), reoperations, complications, health-care costs, and mortality. Outcomes were assessed at 3 months, 1 year, and annually for up to 20 years. Overall, the results revealed no statistically significant difference in OKS or other clinical outcomes, although most estimates numerically favoured patellar resurfacing. Patellar resurfacing produced significantly more quality-adjusted life-years without increasing overall 20-year health-care costs, suggesting that it is likely the preferred and more cost-effective strategy.