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Title: The Knee Arthroplasty Trial (KAT) : design features, baseline characteristics and two-year functional outcomes after alternative approaches to knee replacement
Authors: Campbell, Marion Kay
Fiddian, Nick
Fitzpatrick, Ray
Grant, Adrian Maxwell
Gray, Alastair
Morris, Richard
Murray, David
Rowley, David
Johnston, Linda
MacLennan, Graeme Stewart
McCormack, Kirsty
Ramsay, Craig R
Walker, Allan
KAT Trial Group
University of Aberdeen, School of Medicine & Dentistry, Division of Applied Health Sciences
Keywords: Arthroplasty, Replacement, Knee
Recovery of Function
Quality of Life
Issue Date: 1-Jan-2009
Publisher: Wiley
Citation: Campbell, M., Fiddian, F., Fitzpatrick, R., Grant, A., Gray, A., Morris, R., Murray, D., Rowley, D., Johnston, L., MacLennan, G., McCormak, K., Ramsay, C., and Walker, A. (2009). Journal of Bone and Joint Surgery, 91(1), pp. 134-141.
Abstract: Background: The aim of continued development of total knee replacement systems has been the further improvement of the quality of life and increasing the duration of prosthetic survival. Our goal was to evaluate the effects of several design features, including metal backing of the tibial component, patellar resurfacing, and a mobile bearing between the tibial and femoral components, on the function and survival of the implant. Methods: A pragmatic, multicenter, randomized, controlled trial involving 116 surgeons in thirty-four centers in the United Kingdom was performed; 2352 participants were randomly allocated to be treated with or without a metal backing of the tibial component (409), with or without patellar resurfacing (1715), and/or with or without a mobile bearing (539). Randomization to more than one comparison was allowed. The primary outcome measures were the Oxford Knee Score (OKS), Short Form-12, EuroQol-5D, and the need for additional surgery. The results up to two years postoperatively are reported. Results: Functional status and quality-of-life scores were low at baseline but improved markedly across all trial groups following knee replacement (mean overall OKS, 17.98 points at baseline and 34.82 points at two years). Most of the change was observed at three months after the surgery. Six percent of the patients had additional knee surgery within two years. There was no evidence of differences in clinical, functional, or quality-of-life measures between the randomized groups at two years. Conclusions: Patients have substantial improvement following total knee replacement. This is the first adequately powered randomized controlled trial, of which we are aware, in which the effects of metal backing, patellar resurfacing, and a mobile bearing were investigated. We found no evidence of an effect of these variants on the rate of early complications or on functional recovery up to two years after total knee replacement. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
ISSN: 0021-9355
Appears in Collections:Applied Health Sciences research
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