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dc.contributor.authorCampbell, Marion Kayen
dc.contributor.authorFiddian, Nick
dc.contributor.authorFitzpatrick, Ray
dc.contributor.authorGrant, Adrian Maxwellen
dc.contributor.authorGray, Alastair
dc.contributor.authorMorris, Richard
dc.contributor.authorMurray, David
dc.contributor.authorRowley, David
dc.contributor.authorJohnston, Linda
dc.contributor.authorMacLennan, Graeme Stewarten
dc.contributor.authorMcCormack, Kirsty
dc.contributor.authorRamsay, Craig Ren
dc.contributor.authorWalker, Allan
dc.contributor.authorKAT Trial Groupen
dc.date.accessioned2009-03-17T11:46:52Z
dc.date.available2009-03-17T11:46:52Z
dc.date.issued2009-01-01
dc.identifier.citationCampbell, M., Fiddian, F., Fitzpatrick, R., Grant, A., Gray, A., Morris, R., Murray, D., Rowley, D., Johnston, L., MacLennan, G., McCormak, K., Ramsay, C., and Walker, A. (2009). Journal of Bone and Joint Surgery, 91(1), pp. 134-141.en
dc.identifier.issn0021-9355
dc.identifier.otherPURE: 1159709
dc.identifier.urihttp://hdl.handle.net/2164/272
dc.description.abstractBackground: 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. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.en
dc.description.sponsorshipNIHR Health Technology Assessment Programme (Project Number 95/10/01); Howmedica Osteonics; Zimmer; DePuy, a Johnson and Johnson company; Corin Medical; Smith and Nephew Healthcare. Biomet Merck; and Wright Cremascolien
dc.format.extent134292 bytes
dc.format.extent8 p.
dc.format.mimetypeapplication/pdf
dc.language.isoenen
dc.publisherWileyen
dc.subjectArthroplasty, Replacement, Kneeen
dc.subjectRecovery of Functionen
dc.subjectQuality of Lifeen
dc.subject.lccRD Surgeryen
dc.titleThe Knee Arthroplasty Trial (KAT) : design features, baseline characteristics and two-year functional outcomes after alternative approaches to knee replacementen
dc.typeJournal Articleen
dc.typeTexten
dc.contributor.institutionUniversity of Aberdeen, School of Medicine & Dentistry, Division of Applied Health Sciencesen
dc.description.statusPeer revieweden
dc.identifier.doihttp://dx.doi.org/10.2106/JBJS.G.01074


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