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NIHR research identifies who’s most likely to need knee replacement surgery redone


Research funded by the NIHR has identified which groups of people are most likely to develop a severe infection after knee replacement surgery and therefore need the joint replacement redone.

In the largest every study carried out, NIHR researchers at the University of Bristol found that patients who are under 60 years of age, males, those with chronic pulmonary disease, diabetes, or liver disease, and people with a higher body mass index are at increased risk of having the joint replacement redone (known as revision) due to infection.

Knee replacement, used mainly to treat pain and disability caused by osteoarthritis, is a common procedure, with around 110,000 operations performed annually in the UK. Around 1% of patients experience deep infection - a rare but serious complication of the surgery. This causes considerable distress and often requires long and protracted treatments, including revision.

This research, published in the Lancet Infectious Diseases, used data from the National Joint Registry (NJR) for England, Wales, Northern Ireland and the Isle of Man linked to the Hospital Episode Statistics database.

It showed that the reason for surgery, the type of procedure performed and the type of prosthesis and its fixation also influenced the risk of needing revision surgery for infection.

The research was funded by NIHR Programme Grants for Applied Research and supported by the NIHR Bristol Biomedical Research Centre.

Michael Whitehouse, Reader and Consultant in Trauma and Orthopaedic Surgery in the Musculoskeletal Research Unit of the Bristol Medical School: Translational Health Sciences, said: “This NIHR research has identified key patient and surgical characteristics which influence the risk of revision for infection following knee replacement, and specifically the risk of further surgery for infection two years or more after the initial operation. This information provides me with the strong evidence I need to discuss the risk of infection with my patients undergoing knee replacement and helps us identify strategies to minimise that risk for them.”

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