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Partial Or Total Knee Replacement Surgery – Which Is Safest?

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Total knee replacement is associated with greater risks when compared to partial knee replacement, according to a study carried out by scientists from the University of Oxford.

Life-threatening issues arising from knee replacement are very rare, but there are potential complications. The researchers found that total knee replacement procedures can increase the risk of death by four times in the month after the surgery is performed and they also pose a 15% higher risk of dying during the first eight years after the surgery than people who undergo partial knee replacements.

In addition, patients having total replacements are twice as likely to develop problems like thrombosis, heart attack and deep infection compared to patients with partial replacements. Moreover, the risk of stroke was three times greater and patients were four times more likely to require blood transfusions. Patients with total replacements were also more likely to need a re-operation during the first year after the surgery.

Other findings show that partial knee replacement patients have a 40% greater risk of needing revision surgery during the first eight years after the procedure compared to total knee replacement patients.

But patients are likely to be be more concerned about avoiding death and major complications, such as heart attack or stroke, than reoperations, said Professor David Murray from the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences at the University of Oxford, who led the research.

To make the numbers simple to understand, if 100 individuals undergo a partial knee replacement procedure rather than a total one, the result will be one fewer death and three additional reoperations during the first four years after the procedure, Professor Murray said.

His colleague Alex Liddle, an Arthritis Research UK clinical research fellow, who ran the study, noted that partial and total knee replacements are both successful treatments and both have advantages and disadvantages. The choice of which procedure to offer will depend on the requirements and expectations of individual patients, he added.

Total knee replacement is one of the most common surgical interventions in the UK. More than 76,000 are performed every year and just 5% of patients are in need of revision surgery over a ten-year period, the report said.