The Knee Arthroplasty Trial (KAT)

design features, baseline characteristics, and two-year functional outcomes after alternative approaches to knee replacement

Marion Campbell, Nick Fiddian, Ray Fitzpatrick, Adrian Grant, Alastair Gray, Richard Morris, David Murray, David Rowley, Linda Johnston, Graeme MacLennan, Kirsty McCormack, Craig Ramsay, Allan Walker, KAT Trial Group

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background: The aim of continued development of total knee replacement systems has been the further improvement of the quality of life and increasing the duration of prosthetic survival. Our goal was to evaluate the effects of several design features, including metal backing of the tibial component, patellar resurfacing, and a mobile bearing between the tibial and femoral components, on the function and survival of the implant.

Methods: A pragmatic, multicenter, randomized, controlled trial involving 116 surgeons in thirty-four centers in the United Kingdom was performed; 2352 participants were randomly allocated to be treated with or without a metal backing of the tibial component (409), with or without patellar resurfacing (1715), and/or with or without a mobile bearing (539). Randomization to more than one comparison was allowed. The primary outcome measures were the Oxford Knee Score (OKS), Short Form-12, EuroQol-5D, and the need for additional surgery. The results up to two years postoperatively are reported.

Results: Functional status and quality-of-life scores were low at baseline but improved markedly across all trial groups following knee replacement (mean overall OKS, 17.98 points at baseline and 34.82 points at two years). Most of the change was observed at three months after the surgery. Six percent of the patients had additional knee surgery within two years. There was no evidence of differences in clinical, functional, or quality-of-life measures between the randomized groups at two years.

Conclusions: Patients have substantial improvement following total knee replacement. This is the first adequately powered randomized controlled trial, of which we are aware, in which the effects of metal backing, patellar resurfacing, and a mobile bearing were investigated. We found no evidence of an effect of these variants on the rate of early complications or on functional recovery up to two years after total knee replacement.

Original languageEnglish
Pages (from-to)134-141
Number of pages8
JournalThe Journal of Bone & Joint Surgery. American Volume
Volume91
Issue number1
DOIs
Publication statusPublished - 1 Jan 2009

Keywords

  • survivorship analysis
  • meniscal bearings
  • 10-year
  • system

Cite this

The Knee Arthroplasty Trial (KAT) : design features, baseline characteristics, and two-year functional outcomes after alternative approaches to knee replacement. / Campbell, Marion; Fiddian, Nick; Fitzpatrick, Ray; Grant, Adrian; Gray, Alastair; Morris, Richard; Murray, David; Rowley, David; Johnston, Linda; MacLennan, Graeme; McCormack, Kirsty; Ramsay, Craig; Walker, Allan; KAT Trial Group.

In: The Journal of Bone & Joint Surgery. American Volume, Vol. 91, No. 1, 01.01.2009, p. 134-141.

Research output: Contribution to journalArticle

Campbell, Marion ; Fiddian, Nick ; Fitzpatrick, Ray ; Grant, Adrian ; Gray, Alastair ; Morris, Richard ; Murray, David ; Rowley, David ; Johnston, Linda ; MacLennan, Graeme ; McCormack, Kirsty ; Ramsay, Craig ; Walker, Allan ; KAT Trial Group. / The Knee Arthroplasty Trial (KAT) : design features, baseline characteristics, and two-year functional outcomes after alternative approaches to knee replacement. In: The Journal of Bone & Joint Surgery. American Volume. 2009 ; Vol. 91, No. 1. pp. 134-141.
@article{677d6ba993824da6a54cb930aafa537f,
title = "The Knee Arthroplasty Trial (KAT): design features, baseline characteristics, and two-year functional outcomes after alternative approaches to knee replacement",
abstract = "Background: The aim of continued development of total knee replacement systems has been the further improvement of the quality of life and increasing the duration of prosthetic survival. Our goal was to evaluate the effects of several design features, including metal backing of the tibial component, patellar resurfacing, and a mobile bearing between the tibial and femoral components, on the function and survival of the implant. Methods: A pragmatic, multicenter, randomized, controlled trial involving 116 surgeons in thirty-four centers in the United Kingdom was performed; 2352 participants were randomly allocated to be treated with or without a metal backing of the tibial component (409), with or without patellar resurfacing (1715), and/or with or without a mobile bearing (539). Randomization to more than one comparison was allowed. The primary outcome measures were the Oxford Knee Score (OKS), Short Form-12, EuroQol-5D, and the need for additional surgery. The results up to two years postoperatively are reported. Results: Functional status and quality-of-life scores were low at baseline but improved markedly across all trial groups following knee replacement (mean overall OKS, 17.98 points at baseline and 34.82 points at two years). Most of the change was observed at three months after the surgery. Six percent of the patients had additional knee surgery within two years. There was no evidence of differences in clinical, functional, or quality-of-life measures between the randomized groups at two years. Conclusions: Patients have substantial improvement following total knee replacement. This is the first adequately powered randomized controlled trial, of which we are aware, in which the effects of metal backing, patellar resurfacing, and a mobile bearing were investigated. We found no evidence of an effect of these variants on the rate of early complications or on functional recovery up to two years after total knee replacement.",
keywords = "survivorship analysis, meniscal bearings, 10-year, system",
author = "Marion Campbell and Nick Fiddian and Ray Fitzpatrick and Adrian Grant and Alastair Gray and Richard Morris and David Murray and David Rowley and Linda Johnston and Graeme MacLennan and Kirsty McCormack and Craig Ramsay and Allan Walker and {KAT Trial Group}",
year = "2009",
month = "1",
day = "1",
doi = "10.2106/JBJS.G.01074",
language = "English",
volume = "91",
pages = "134--141",
journal = "The Journal of Bone & Joint Surgery. American Volume",
issn = "0021-9355",
publisher = "Journal of Bone and Joint Surgery Inc.",
number = "1",

}

TY - JOUR

T1 - The Knee Arthroplasty Trial (KAT)

T2 - design features, baseline characteristics, and two-year functional outcomes after alternative approaches to knee replacement

AU - Campbell, Marion

AU - Fiddian, Nick

AU - Fitzpatrick, Ray

AU - Grant, Adrian

AU - Gray, Alastair

AU - Morris, Richard

AU - Murray, David

AU - Rowley, David

AU - Johnston, Linda

AU - MacLennan, Graeme

AU - McCormack, Kirsty

AU - Ramsay, Craig

AU - Walker, Allan

AU - KAT Trial Group

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Background: The aim of continued development of total knee replacement systems has been the further improvement of the quality of life and increasing the duration of prosthetic survival. Our goal was to evaluate the effects of several design features, including metal backing of the tibial component, patellar resurfacing, and a mobile bearing between the tibial and femoral components, on the function and survival of the implant. Methods: A pragmatic, multicenter, randomized, controlled trial involving 116 surgeons in thirty-four centers in the United Kingdom was performed; 2352 participants were randomly allocated to be treated with or without a metal backing of the tibial component (409), with or without patellar resurfacing (1715), and/or with or without a mobile bearing (539). Randomization to more than one comparison was allowed. The primary outcome measures were the Oxford Knee Score (OKS), Short Form-12, EuroQol-5D, and the need for additional surgery. The results up to two years postoperatively are reported. Results: Functional status and quality-of-life scores were low at baseline but improved markedly across all trial groups following knee replacement (mean overall OKS, 17.98 points at baseline and 34.82 points at two years). Most of the change was observed at three months after the surgery. Six percent of the patients had additional knee surgery within two years. There was no evidence of differences in clinical, functional, or quality-of-life measures between the randomized groups at two years. Conclusions: Patients have substantial improvement following total knee replacement. This is the first adequately powered randomized controlled trial, of which we are aware, in which the effects of metal backing, patellar resurfacing, and a mobile bearing were investigated. We found no evidence of an effect of these variants on the rate of early complications or on functional recovery up to two years after total knee replacement.

AB - Background: The aim of continued development of total knee replacement systems has been the further improvement of the quality of life and increasing the duration of prosthetic survival. Our goal was to evaluate the effects of several design features, including metal backing of the tibial component, patellar resurfacing, and a mobile bearing between the tibial and femoral components, on the function and survival of the implant. Methods: A pragmatic, multicenter, randomized, controlled trial involving 116 surgeons in thirty-four centers in the United Kingdom was performed; 2352 participants were randomly allocated to be treated with or without a metal backing of the tibial component (409), with or without patellar resurfacing (1715), and/or with or without a mobile bearing (539). Randomization to more than one comparison was allowed. The primary outcome measures were the Oxford Knee Score (OKS), Short Form-12, EuroQol-5D, and the need for additional surgery. The results up to two years postoperatively are reported. Results: Functional status and quality-of-life scores were low at baseline but improved markedly across all trial groups following knee replacement (mean overall OKS, 17.98 points at baseline and 34.82 points at two years). Most of the change was observed at three months after the surgery. Six percent of the patients had additional knee surgery within two years. There was no evidence of differences in clinical, functional, or quality-of-life measures between the randomized groups at two years. Conclusions: Patients have substantial improvement following total knee replacement. This is the first adequately powered randomized controlled trial, of which we are aware, in which the effects of metal backing, patellar resurfacing, and a mobile bearing were investigated. We found no evidence of an effect of these variants on the rate of early complications or on functional recovery up to two years after total knee replacement.

KW - survivorship analysis

KW - meniscal bearings

KW - 10-year

KW - system

U2 - 10.2106/JBJS.G.01074

DO - 10.2106/JBJS.G.01074

M3 - Article

VL - 91

SP - 134

EP - 141

JO - The Journal of Bone & Joint Surgery. American Volume

JF - The Journal of Bone & Joint Surgery. American Volume

SN - 0021-9355

IS - 1

ER -