Evidence map›Paper›PMID 32369436›Full record

Trial reportHealth technology assessment (Winchester, England)2020

Total versus partial knee replacement in patients with medial compartment knee osteoarthritis: the TOPKAT RCT.

David J Beard, Loretta J Davies, Jonathan A Cook, Graeme MacLennan, Andrew Price, Seamus Kent, Jemma Hudson, Andrew Carr, Jose Leal, Helen Campbell and 4 more

Registry-linked trialOpen access · diamondAbstract readMulticenter StudyPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Health technology assessment (Winchester, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01352247 (Total or Partial Knee Arthroplasty Trial), which is not on this map. Cited by 25 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 2 pooled it
5.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01352247 nacompletednot on this map

Total or Partial Knee Arthroplasty Trial

TypeinterventionalSponsorUniversity of OxfordRan2010 to 2024Enrolled500ConditionsKnee OsteoarthritisArmsUnicompartmental Knee Replacement, Total Knee Replacement
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 51 citations in OpenAlex.

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  6. Visual inspection provides precise intraoperative evaluation of tibial slope during unicompartmental knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

David J BeardNuffield Department of Orthopaedics, University of Oxford, Oxford, UK.ORCID 0000-0001-7884-6389
Loretta J DaviesNuffield Department of Orthopaedics, University of Oxford, Oxford, UK.ORCID 0000-0002-4721-356X
Jonathan A CookHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.ORCID 0000-0002-4156-6989
Graeme MacLennanHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.ORCID 0000-0002-1039-5646
Andrew PriceNuffield Department of Orthopaedics, University of Oxford, Oxford, UK.ORCID 0000-0002-4258-5866
Seamus KentDepartment of Public Health, University of Oxford, Oxford, UK.ORCID 0000-0001-7298-3163
Jemma HudsonHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.ORCID 0000-0002-6440-6419
Andrew CarrNuffield Department of Orthopaedics, University of Oxford, Oxford, UK.ORCID 0000-0001-5940-1464
Jose LealDepartment of Public Health, University of Oxford, Oxford, UK.ORCID 0000-0001-7870-6730
Helen CampbellDepartment of Public Health, University of Oxford, Oxford, UK.ORCID 0000-0003-2070-7794
Ray FitzpatrickDepartment of Public Health, University of Oxford, Oxford, UK.ORCID 0000-0003-0607-0563
Nigel ArdenNuffield Department of Orthopaedics, University of Oxford, Oxford, UK.ORCID 0000-0002-3452-3382
David MurrayNuffield Department of Orthopaedics, University of Oxford, Oxford, UK.ORCID 0000-0002-0839-3166
Marion K CampbellHealth Services Research Unit, University of Aberdeen, Aberdeen, UK.ORCID 0000-0001-5386-4097
Nuffield Orthopaedic Centre · GBUniversity of Aberdeen · GBUniversity of Oxford · GB

Funding

Chief Scientist Office HSRU1Department of Health 08/14/08
6 · The paper itself

Abstract

backgroundLate-stage medial compartment knee osteoarthritis can be treated using total knee replacement or partial (unicompartmental) knee replacement. There is high variation in treatment choice and insufficient evidence to guide selection.

objectiveTo assess the clinical effectiveness and cost-effectiveness of partial knee replacement compared with total knee replacement in patients with medial compartment knee osteoarthritis. The findings are intended to guide surgical decision-making for patients, surgeons and health-care providers.

designThis was a randomised, multicentre, pragmatic comparative effectiveness trial that included an expertise component. The target sample size was 500 patients. A web-based randomisation system was used to allocate treatments.

settingTwenty-seven NHS hospitals (68 surgeons).

participantsPatients with medial compartment knee osteoarthritis.

interventionsThe trial compared the overall management strategy of partial knee replacement treatment with total knee replacement treatment. No specified brand or subtype of implant was investigated.

main outcome measuresThe Oxford Knee Score at 5 years was the primary end point. Secondary outcomes included activity scores, global health measures, transition items, patient satisfaction (Lund Score) and complications (including reoperation, revision and composite 'failure' - defined by minimal Oxford Knee Score improvement and/or reoperation). Cost-effectiveness was also assessed.

resultsA total of 528 patients were randomised (partial knee replacement, LIMITATIONS: It was not possible to blind patients in this study and there was some non-compliance with the allocated treatment interventions. Surgeons providing partial knee replacement were relatively experienced with the procedure.

conclusionsBoth total knee replacement and partial knee replacement are effective, offer similar clinical outcomes and have similar reoperation and complication rates. Some patient-reported measures of treatment approval were significantly higher for partial knee replacement than for total knee replacement. Partial knee replacement was more cost-effective (more effective and cost saving) than total knee replacement at 5 years. FUTURE WORK: Further (10-year) follow-up is in progress to assess the longer-term stability of these findings.

trial registrationCurrent Controlled Trials ISRCTN03013488 and ClinicalTrials.gov NCT01352247.

fundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in

Indexed as

Clinical ProtocolsTreatment OutcomeAgedArthroplasty, Replacement, KneeCost-Benefit AnalysisFemaleHumansMaleMiddle AgedOsteoarthritis, KneePatient SatisfactionQuality-Adjusted Life YearsReoperationSurveys and QuestionnairesUnited KingdomARTHROPLASTYDECISION-MAKINGEQUIPOISEEXPERTISEKNEE REPLACEMENTOSTEOARTHRITISPARTIAL KNEE REPLACEMENTTOTAL KNEE REPLACEMENT

Identifiers

PMID32369436
PMCPMC7232134
OpenAlexW3021897058

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.