ArticleBMJ open2018
Cost-effectiveness of unicompartmental compared with total knee replacement: a population-based study using data from the National Joint Registry for England and Wales.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Pooled it
- Patient relevant outcomes of unicompartmental versus total knee replacement: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- Total versus partial knee replacement in patients with medial compartment knee osteoarthritis: the TOPKAT RCT.Health technology assessment (Winchester, England) · 2020Trial
- Excellent survivorship and functional outcomes following lateral unicompartmental knee arthroplasty in patients aged 55 years or younger.Journal of experimental orthopaedics · 2026Article
- Article
- Friction and Cartilage Wear in Hemiarthroplasty: A Systematic Review of Key Influencing Factors.Lubricants (Basel, Switzerland) · 2026Article
- Early institutional adoption and outcomes from 154 consecutive medial mobile-bearing unicompartmental knee arthroplasties: a single-center experience after implant introduction.Archives of orthopaedic and trauma surgery · 2025Article
- Optimising outcomes in lateral unicompartmental knee arthroplasty: Analysing 25 years of registry data.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Decision Analysis in the Management of Hip and Knee Osteoarthritis: A Systematic Review.Cureus · 2025Review
- Cost-effectiveness of total shoulder arthroplasty compared with hemiarthroplasty: a study using data from the National Joint Registry.BMJ open · 2025Article
- The inclination of the tibial component has an impact on fracture stability in unicompartmental knee arthroplasty: an artificial bone study.Frontiers in bioengineering and biotechnology · 2025Article
- Article
- Revision Anterior Cruciate Ligament Reconstruction and Medial Unicompartmental Knee Replacement.Journal of orthopaedic case reports · 2024Article
- Robot-assisted partial knee replacement versus standard total knee replacement (RoboKnees): a protocol for a pilot randomized controlled trial.Pilot and feasibility studies · 2024Article
- The effect of reduced bone mineral density on elective total hip arthroplasty outcomes.Archives of orthopaedic and trauma surgery · 2023Article
- A matched comparison of cementless unicompartmental and total knee replacement outcomes based on the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man.Acta orthopaedica · 2022Article
- Failure to Meet Same-Day Discharge is Not a Predictor of Adverse Outcomes.Archives of orthopaedic and trauma surgery · 2022Article
- St Georg Sled medial unicompartmental arthroplasty: survivorship analysis and function at 20 years follow up.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Factors Limiting Subgroup Analysis in Cost-Effectiveness Analysis and a Call for Transparency.PharmacoEconomics · 2022Article
- Robotic-Arm Assisted Technology's Impact on Knee Arthroplasty and Associated Healthcare Costs.Journal of health economics and outcomes research · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the value for money of unicompartmental knee replacement (UKR) compared with total knee replacement (TKR).
designA lifetime Markov model provided the framework for the analysis.
settingData from the National Joint Registry (NJR) for England and Wales primarily informed the analysis.
participantsPropensity score matched patients in the NJR who received either a UKR or TKR.
interventionsUKR is a less invasive alternative to TKR, where only the compartment affected by osteoarthritis is replaced. PRIMARY OUTCOME MEASURES: Incremental quality-adjusted life years (QALYs) and healthcare system costs.
resultsThe provision of UKR is expected to lead to a gain in QALYs compared with TKR for all age and gender subgroups (male: <60 years: 0.12, 60-75 years: 0.20, 75+ years: 0.19; female: <60 years: 0.10, 60-75 years: 0.28, 75+ years: 0.44) and a reduction in costs (male: <60: £-1223, 60-75 years: £-1355, 75+ years: £-2005; female: <60 years: £-601, 60-75 years: £-935, 75+ years: £-1102 per patient over the lifetime). UKR is expected to lead to a reduction in QALYs compared with TKR when performed by surgeons with low UKR utilisation but an increase among those with high utilisation (<10%, median 6%: -0.04, ≥10%, median 27%: 0.26). Regardless of surgeon usage, costs associated with UKR are expected to be lower than those of TKR (<10%: £-127, ≥10%: £-758).
conclusionsUKR can be expected to generate better health outcomes and lower lifetime costs than TKR. Surgeon usage of UKR does, however, have a significant impact on the cost-effectiveness of the procedure. To achieve the best results, surgeons need to perform a sufficient proportion of knee replacements as UKR. Low usage surgeons may therefore need to broaden their indications for UKR.
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Registered trials
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