In 1989 Kozinn and Scott published what were at the time the ideal indications for Partial Knee Replacement1. According to their criteria, only 5% of patients were candidates for PKR. This may partly explain why there is low utilisation of PKA today, with it only being used for 8%2,3 of knee replacements worldwide.
An intact, functioning ACL plays a critical role in determining candidacy for PKA.
- One study showed that 47.6% of all knee replacement patients are candidates for PKA4
- In a study of consecutive TKAs by Lee et al.5 61% of patients were found to have an intact ACL
- In a more recent presentation, Berend, et al.6 found 53% of knee replacement candidates had a normal, intact ACL
Utilisation: closing the revision gap
The revision gap between PKA and TKA reported in national joint registries has been reduced with increased utilisation of PKRs:
- Tregonning, et al in a study reviewing the New Zealand Joint Registry found that surgeons performing at least 12 PKRs per year are found to have a decreased revision rate7
- Liddle, AD. et al8 found in the National Joint Registry for England and Wales that surgeons utilising PKA for at least 20% of their annual knee replacements experienced a dramatic decrease in their revision rate
What's more, with research showing that up to 61% of patients5 could be candidates for PKA, the optimal usage of performing at least 12 partial knee replacements per year7 can easily be achieved.