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Total Knee Replacement Proof Is ‘Lacking’

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The UK regulator said the National Joint Registry was a “key source” of safety and performance data. Fear over other false implants, such as PIP breast implants and metal hip replacement, have been raised recently.

The research states more observation is required on the long term effects of joint replacements, and that there is no immediate health risk. Prof Andrew Carr, part of the research team from the University of Oxford, said: “We’re not sitting on a metal-on-metal situation, but there could be something not being picked up as there are not the processes going on for monitoring [total knee replacements].”

However, he said this was “often with little or no evidence of effectiveness or cost-effectiveness” and that regulations should be made tougher and “more along the lines of introducing new drugs”.

The Medicines and Healthcare products Regulatory Agency (MHRA) said safety data for more than 80,000 knee joint replacements in the UK in 2010 has been collected.

Dr Susanne Ludgate, MHRA’s clinical director said: “The National Joint Registry (NJR) is a key source of information on the long-term safety and performance of knee joint replacements and is the largest such registry in the world. The NJR assists surgeons in making choices and regulators in monitoring performance. Since April 2003 all knee joint replacement operations in England and Wales have been recorded in the NJR.”

Data from the NJR showed up no health concerns, however there is a need to improve measure of patients’ experiences e.g. pain levels and range of movement.

Arthritis Research UK’s medical director, Prof Alan Silman said: “Given the current concerns raised by the metal-on-metal hip replacements – although there is no evidence that there are similar implications for knee replacements – it’s appropriate to take stock of the advantages and costs of knee joint replacement. Undoubtedly it produces major benefits for patients and the need will be become greater as the population ages and becomes more obese. However it’s equally important that we are able to understand and measure the benefits of surgery, and we are currently supporting research to measure the benefits to patients in a more effective way, and also to predict who should have the operation, and when.”

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