Knee prostheses under scrutiny: safety questioned

In the wake of controversy over faulty breast and hip implants, The Lancet has published a review of knee replacement surgery, co-authored by Australian orthopaedic surgeon Professor Stephen Graves, director of the National Joint Replacement Registry.

While orthopaedic manufacturers are continually introducing new designs and clinicians expect this will improve outcomes, “there is evidence to suggest that this belief is incorrect”, the experts said.

Looking at the reasons for revision surgery, they noted that implant wear was most common and that data from joint replacement registries showed revision was 2.5 times higher in patients with osteoarthritis younger than 65 years compared to older patients.

The 10 year risk of revision after primary total knee replacement for patients with osteoarthritis was 4% in Sweden and 6% in Australia, but the increasingly young age at which prostheses were being implanted suggested a growing future