Revision total knee replacement: A two-year review of complexity data and regional workload in South West England

Patrick Reynolds*, Jonathan Phillips, Jonathan T Evans, David Searle, Andrew Toms

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Background
The GIRFT report (2012) sought to address the need for sustainable orthopaedic treatment delivered through regional “networks”; the aim being improved care, decreased cost and reduced revision rate. The aims of this study were to record the number and complexity of revision total knee replacements within a regional network using a validated classification over a two-year period and audit this against National Joint Registry (NJR) records.

Methods
A region-wide network model where revision TKR cases are assessed locally using the Revision Knee Complexity Classification (RKCC) and local multi-disciplinary team (MDT) was introduced. Data was collected from 8 revision centres over a two-year period using the RKCC. The case volume was audited against the NJR records.

Results
In year 1 (01/01/2018–31/12/2018) 237 RKCC forms were collected from eight centres. 46% of R2s and 63% of R3s were carried out at the higher volume centre. 211 K2 forms were received by the NJR. In year 2 (01/01/2019–31/12/2019) 252 RKCC forms were collected. 46% of R2s and 64% of R3s were carried out at the higher volume centre. 267 K2 forms were received by the NJR.

Conclusion
This is the first published set of revision knee data showing complexity percentages across a region. The RKCC has been successfully introduced into the region and this has been sustained. The findings show that a successful network has been established and majority of complex revision knee surgery is occurring in the high-volume centre. NJR data suggests that the RKCC is capturing the complexity and volume of our work accurately.
Original languageEnglish
Pages (from-to)22-27
Number of pages6
JournalThe Knee
Volume31
Early online date7 Jun 2021
DOIs
Publication statusE-pub ahead of print - 7 Jun 2021

Bibliographical note

Funding Information:
The authors acknowledge the contribution to this study by the Southwest Orthopaedic Research Division (SWORD); a collaborative of regional orthopaedic specialist trainees. We also acknowledge the contribution and participation of the members of the South West Knee Group to the development of the MDT networks and this study as a whole.

Publisher Copyright:
© 2021 Elsevier B.V.

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