Evidence map›Paper›PMID 30782341›Full record

SynthesisLancet (London, England)2019

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.

Jonathan T Evans, Robert W Walker, Jonathan P Evans, Ashley W Blom, Adrian Sayers, Michael R Whitehouse

Erratum issued Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lancet (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05944679 (Prospective Randomized Study of the Clinical Utility to Follow-up Radiographs During the First Year of Knee Replacement Surgery), which is not on this map. Cited by 257 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
257citing papers in PubMed, 16 pooled it
88.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT05944679 nacompletednot on this mapstarted 2022, after this paper: background citation

Prospective Randomized Study of the Clinical Utility to Follow-up Radiographs During the First Year of Knee Replacement Surgery

TypeinterventionalSponsorCorporacion Parc TauliRan2022 to 2024Enrolled200ConditionsProsthetic Knee SurgeryArmsNo Xray, Xray
3 · Its place in the literature

Who cites it

257 citing papers in PubMed, 16 syntheses or guidelines pooled it, 786 citations in OpenAlex.

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197 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 5 institutions in 1 country.

Jonathan T EvansMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK. Electronic address: j.t.evans@bristol.ac.uk.
Robert W WalkerDepartment of Trauma and Orthopaedics, Torbay and South Devon NHS Foundation Trust, Torquay, UK.
Jonathan P EvansHealth and Policy Research Group, University of Exeter, Exeter, UK.
Ashley W BlomMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals, Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.
Adrian SayersMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK.
Michael R WhitehouseMusculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals, Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.
University of Exeter · GBSouthmead Hospital · GBTorbay and South Devon NHS Foundation Trust · GBUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity of Bristol · GB

Funding

Medical Research Council MR/L01226X/1
6 · The paper itself

Abstract

backgroundKnee replacements are the mainstay of treatment for end-stage osteoarthritis and are effective. Given time, all knee replacements will fail and knowing when this failure might happen is important. We aimed to establish how long a knee replacement lasts.

methodsIn this systematic review and meta-analysis, we searched MEDLINE and Embase for case series and cohort studies published from database inception until July 21, 2018. Articles reporting 15 year or greater survival of primary total knee replacement (TKR), unicondylar knee replacement (UKR), and patellofemoral replacements in patients with osteoarthritis were included. Articles that reviewed specifically complex primary surgeries or revisions were excluded. Survival and implant data were extracted, with all-cause survival of the knee replacement construct being the primary outcome. We also reviewed national joint replacement registry reports and extracted the data to be analysed separately. In the meta-analysis, we weighted each series and calculated a pooled survival estimate for each data source at 15 years, 20 years, and 25 years, using a fixed-effects model. This study is registered with PROSPERO, number CRD42018105188.

findingsFrom 4363 references found by our initial search, we identified 33 case series in 30 eligible articles, which reported all-cause survival for 6490 TKRs (26 case series) and 742 UKRs (seven case series). No case series reporting on patellofemoral replacements met our inclusion criteria, and no case series reported 25 year survival for TKR. The estimated 25 year survival for UKR (based on one case series) was 72·0% (95% CI 58·0-95·0). Registries contributed 299 291 TKRs (47 series) and 7714 UKRs (five series). The pooled registry 25 year survival of TKRs (14 registries) was 82·3% (95% CI 81·3-83·2) and of UKRs (four registries) was 69·8% (67·6-72·1).

interpretationOur pooled registry data, which we believe to be more accurate than the case series data, shows that approximately 82% of TKRs last 25 years and 70% of UKRs last 25 years. These findings will be of use to patients and health-care providers; further information is required to predict exactly how long specific knee replacements will last.

fundingThe National Joint Registry for England, Wales, Northern Ireland, and Isle of Man and the Royal College of Surgeons of England.

Indexed as

Prosthesis FailureRegistriesReoperationArthroplasty, Replacement, KneeFollow-Up StudiesHumansOsteoarthritis, KneeTime Factors

Identifiers

PMID30782341
PMCPMC6381229
OpenAlexW2912366334

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.