After much anticipation, the long-awaited results of the Total or Partial Knee Arthroplasty Trial (TOPKAT) randomized controlled study for patients who suffer from late-stage isolated medial osteoarthritis of the knee are available.1
At 5 years post-op the cost-effectiveness analysis found that, for the 528 patients included, partial knee replacement (PKR) was more effective and less expensive than total knee replacement (TKR) as a result of slightly better outcomes, lesser surgery costs than TKR and lesser follow-up healthcare costs. TOPKAT also concluded that significantly more PKR patients felt better after the surgery and would undergo the operation again than those who received a TKR.
While both PKR and TKR are effective methods of joint replacement, these results indicate that PKR should likely be considered as the first choice for patients suffering from late-stage isolated medial compartment osteoarthritis. This study shows that choosing PKR over TKR is the more cost-effective option. This is due to lower subsequent utilization of health-care services, fewer outpatient visits in the first two years after the index surgery, and shorter average hospital stays than TKR.