Uni-Knee Research in 2025

LIFETIME HIP & KNEE

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#121: Uni-Knee Research

So, last week told us the robots are not taking over just yet.

Well, at least when it comes to hip replacement..

Robots help us put in the joint replacement.

Of more consequence is often the..

Choice of implant

There were 2 or 3 Uni-Knee papers I liked last year..

One commentary blog +
One evidence-based surgical tip.

Both pointing to how knee surgery takes small steps forward.

Both underpinned by a LARGE leap forward 5yrs before.. from the TOP quality TOPKAT study..

An update of that study was also published in 2025.

The commentary blog asked ‘Are patients being overtreated with total knee replacements?’

I tend to agree.. perhaps we are.

And the paper set out the management of one-sided knee pain..

It was a useful perspective to sense check my own practice.

The surgical tip paper showed..

LARGE implants fitting males 5’7 + taller
MEDIUM implants fitting females 5’5 + taller

Another data point that helps in the operating theatre.

BUT the BIG leap forward came 5yrs earlier...

TOPKAT

TOPKAT changed guidelines and clinical practice..

TOPKAT 2020 showed some patient-reported outcomes measured significantly higher for partial than total knee replacement (solid v dotted line above)..

..with similar rates of re-operation + revision.

This high quality RCT reassured us that:

Both partial + total knees do well (overall)
Partial does slightly better over 5yrs
With NO increase in problems.

TOPKAT 2025 added a couple of data points..

A longer graph that shows..

The difference in clinical outcome narrowing
Re-operation + revision rates remaining similar.
Cost effectiveness remaining in favour of partial knee.

This 10-year update shows the clinical benefit even-ing out

And, again, NO increased problems.

All very reassuring for me and my patients..

Implants do make a difference
The correct choice is important

BUT the difference between different implants is small. So..

Next week

Let’s take a look at the what really makes a difference..

Spoiler alert: it’s you!

I’ve then got a good Dutch paper, a couple of papers on waiting lists and 2 more important papers that I wrote about last year.

That'll wrap up my review of 2025.

Better late than never..

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Duchy Hospital
Truro
TR1 3UP
United Kingdom