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The St. Leger total knee replacement. A false economy?
Mark J Westwood1, Simon P White, Gordon C Bannister
1Trauma and Orthopaedics, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK. markwestwood@ukgateway.net
The Knee
|June 6, 2003
Summary
The St. Leger total knee replacement (TKR) showed worse survivorship than the Kinemax Plus TKR, despite lower initial cost. Revision procedures ultimately made St. Leger more expensive.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Clinical Outcomes Research
Background:
- Osteoarthritis necessitates total knee replacement (TKR) for pain relief and improved function.
- Comparing implant performance is crucial for optimizing patient outcomes and healthcare economics.
- The St. Leger and Kinemax Plus TKRs were evaluated for primary implantation in osteoarthritis patients.
Purpose of the Study:
- To compare the clinical outcomes and survivorship of the St. Leger TKR with the Kinemax Plus TKR.
- To assess the cost-effectiveness of the St. Leger TKR in relation to revision rates.
Main Methods:
- A retrospective review of 53 primary St. Leger TKRs and age/sex-matched Kinemax Plus TKRs.
- Patient outcomes were assessed using Oxford Knee Scores.
- Survivorship analysis was performed to determine implant longevity.
Main Results:
- The St. Leger group demonstrated significantly worse prosthesis survivorship compared to the Kinemax Plus group.
- While Oxford Knee Scores were lower in the St. Leger group, the difference was not statistically significant.
- The St. Leger prosthesis had a lower initial cost (£650) versus the Kinemax Plus (£1150).
Conclusions:
- The St. Leger TKR exhibits inferior survivorship, leading to higher long-term costs due to revision surgeries.
- Despite a lower initial purchase price, the St. Leger prosthesis is not cost-effective in the long run.
- The Kinemax Plus TKR appears to be a more durable and ultimately cost-effective option for treating knee osteoarthritis.