Revision knee replacement surgery in the NHS: a BASK surgical practice guideline

BASK Revision Knee Working Group; N. S. Kalson; J. A. Mathews; J. R.A. Phillips; P. N. Baker; A. J. Price; A. D. Toms; A. Alvand; B. Bloch; D. Barrett; R. Carrington; D. J. Deehan; K. Eyres; A. Gambhir; P. Hopgood; N. Howells; W. Jackson; P. James; L. Jeys; R. Kerry; J. Miles; B. Mockford; R. Morgan-Jones; J. Murray; G. Pavlou; A. Porteous; M. Sarungi; R. Spencer-Jones; P. Walmsley; H. Waterson; J. Whittaker

doi:10.1016/j.knee.2021.01.032

Revision knee replacement surgery in the NHS: a BASK surgical practice guideline

BASK Revision Knee Working Group, N. S. Kalson, J. A. Mathews, J. R.A. Phillips, P. N. Baker, A. J. Price, A. D. Toms^*, A. Alvand, B. Bloch, D. Barrett, R. Carrington, D. J. Deehan, K. Eyres, A. Gambhir, P. Hopgood, N. Howells, W. Jackson, P. James, L. Jeys, R. KerryJ. Miles, B. Mockford, R. Morgan-Jones, J. Murray, G. Pavlou, A. Porteous, M. Sarungi, R. Spencer-Jones, P. Walmsley, H. Waterson, J. Whittaker

^*Corresponding author for this work

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND

Revision knee replacement (KR) is both challenging for the surgical team and expensive for the healthcare provider. Limited high quality evidence is available to guide decision-making.

AIM

To provide guidelines for surgeons and units delivering revision KR services.

METHODS

A formal consensus process was followed by BASK's Revision Knee Working Group, which included surgeons from England, Wales, Scotland and Northern Ireland. This was supported by analysis of National Joint Registry data.

RESULTS

There are a large number of surgeons operating at NHS sites who undertake a small number of revision KR procedures. To optimise patient outcomes and deliver cost-effective care high-volume revision knee surgeons working at high volume centres should undertake revision KR. This document outlines practice guidelines for units providing a revision KR service and sets out: The current landscape of revision KR in England, Wales and Northern Ireland. Service organisation within a network model. The necessary infrastructure required to provide a sustainable revision service. Outcome metrics and auditable standards. Financial mechanisms to support this service model.

CONCLUSIONS

Revision KR patients being treated in the NHS should be provided with the best care available. This report sets out a framework to both guide and support revision KR surgeons and centres to achieve this aim.

Original language	English
Pages (from-to)	353-364
Number of pages	12
Journal	The Knee
Volume	29
Early online date	6 Mar 2021
DOIs	https://doi.org/10.1016/j.knee.2021.01.032
Publication status	Published - 6 Mar 2021

Keywords

Arthroplasty
Guidelines
Infection
Knee
Revision

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10.1016/j.knee.2021.01.032

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BASK Revision Knee Working Group, Kalson, N. S., Mathews, J. A., Phillips, J. R. A., Baker, P. N., Price, A. J., Toms, A. D., Alvand, A., Bloch, B., Barrett, D., Carrington, R., Deehan, D. J., Eyres, K., Gambhir, A., Hopgood, P., Howells, N., Jackson, W., James, P., Jeys, L., ... Whittaker, J. (2021). Revision knee replacement surgery in the NHS: a BASK surgical practice guideline. The Knee, 29, 353-364. https://doi.org/10.1016/j.knee.2021.01.032

@article{73ec2d9e8b534cb089d89b18a0bba8af,

title = "Revision knee replacement surgery in the NHS: a BASK surgical practice guideline",

abstract = "BACKGROUND Revision knee replacement (KR) is both challenging for the surgical team and expensive for the healthcare provider. Limited high quality evidence is available to guide decision-making.AIM To provide guidelines for surgeons and units delivering revision KR services.METHODS A formal consensus process was followed by BASK's Revision Knee Working Group, which included surgeons from England, Wales, Scotland and Northern Ireland. This was supported by analysis of National Joint Registry data.RESULTS There are a large number of surgeons operating at NHS sites who undertake a small number of revision KR procedures. To optimise patient outcomes and deliver cost-effective care high-volume revision knee surgeons working at high volume centres should undertake revision KR. This document outlines practice guidelines for units providing a revision KR service and sets out: The current landscape of revision KR in England, Wales and Northern Ireland. Service organisation within a network model. The necessary infrastructure required to provide a sustainable revision service. Outcome metrics and auditable standards. Financial mechanisms to support this service model.CONCLUSIONS Revision KR patients being treated in the NHS should be provided with the best care available. This report sets out a framework to both guide and support revision KR surgeons and centres to achieve this aim.",

keywords = "Arthroplasty, Guidelines, Infection, Knee, Revision",

author = "{BASK Revision Knee Working Group} and Kalson, {N. S.} and Mathews, {J. A.} and Phillips, {J. R.A.} and Baker, {P. N.} and Price, {A. J.} and Toms, {A. D.} and A. Alvand and B. Bloch and D. Barrett and R. Carrington and Deehan, {D. J.} and K. Eyres and A. Gambhir and P. Hopgood and N. Howells and W. Jackson and P. James and L. Jeys and R. Kerry and J. Miles and B. Mockford and R. Morgan-Jones and J. Murray and G. Pavlou and A. Porteous and M. Sarungi and R. Spencer-Jones and P. Walmsley and H. Waterson and J. Whittaker",

year = "2021",

month = mar,

day = "6",

doi = "10.1016/j.knee.2021.01.032",

language = "English",

volume = "29",

pages = "353--364",

journal = "The Knee",

issn = "0968-0160",

publisher = "Elsevier",

}

BASK Revision Knee Working Group, Kalson, NS, Mathews, JA, Phillips, JRA, Baker, PN, Price, AJ, Toms, AD, Alvand, A, Bloch, B, Barrett, D, Carrington, R, Deehan, DJ, Eyres, K, Gambhir, A, Hopgood, P, Howells, N, Jackson, W, James, P, Jeys, L, Kerry, R, Miles, J, Mockford, B, Morgan-Jones, R, Murray, J, Pavlou, G, Porteous, A, Sarungi, M, Spencer-Jones, R, Walmsley, P, Waterson, H & Whittaker, J 2021, 'Revision knee replacement surgery in the NHS: a BASK surgical practice guideline', The Knee, vol. 29, pp. 353-364. https://doi.org/10.1016/j.knee.2021.01.032

TY - JOUR

T1 - Revision knee replacement surgery in the NHS

T2 - a BASK surgical practice guideline

AU - BASK Revision Knee Working Group

AU - Kalson, N. S.

AU - Mathews, J. A.

AU - Phillips, J. R.A.

AU - Baker, P. N.

AU - Price, A. J.

AU - Toms, A. D.

AU - Alvand, A.

AU - Bloch, B.

AU - Barrett, D.

AU - Carrington, R.

AU - Deehan, D. J.

AU - Eyres, K.

AU - Gambhir, A.

AU - Hopgood, P.

AU - Howells, N.

AU - Jackson, W.

AU - James, P.

AU - Jeys, L.

AU - Kerry, R.

AU - Miles, J.

AU - Mockford, B.

AU - Morgan-Jones, R.

AU - Murray, J.

AU - Pavlou, G.

AU - Porteous, A.

AU - Sarungi, M.

AU - Spencer-Jones, R.

AU - Walmsley, P.

AU - Waterson, H.

AU - Whittaker, J.

PY - 2021/3/6

Y1 - 2021/3/6

N2 - BACKGROUND Revision knee replacement (KR) is both challenging for the surgical team and expensive for the healthcare provider. Limited high quality evidence is available to guide decision-making.AIM To provide guidelines for surgeons and units delivering revision KR services.METHODS A formal consensus process was followed by BASK's Revision Knee Working Group, which included surgeons from England, Wales, Scotland and Northern Ireland. This was supported by analysis of National Joint Registry data.RESULTS There are a large number of surgeons operating at NHS sites who undertake a small number of revision KR procedures. To optimise patient outcomes and deliver cost-effective care high-volume revision knee surgeons working at high volume centres should undertake revision KR. This document outlines practice guidelines for units providing a revision KR service and sets out: The current landscape of revision KR in England, Wales and Northern Ireland. Service organisation within a network model. The necessary infrastructure required to provide a sustainable revision service. Outcome metrics and auditable standards. Financial mechanisms to support this service model.CONCLUSIONS Revision KR patients being treated in the NHS should be provided with the best care available. This report sets out a framework to both guide and support revision KR surgeons and centres to achieve this aim.

AB - BACKGROUND Revision knee replacement (KR) is both challenging for the surgical team and expensive for the healthcare provider. Limited high quality evidence is available to guide decision-making.AIM To provide guidelines for surgeons and units delivering revision KR services.METHODS A formal consensus process was followed by BASK's Revision Knee Working Group, which included surgeons from England, Wales, Scotland and Northern Ireland. This was supported by analysis of National Joint Registry data.RESULTS There are a large number of surgeons operating at NHS sites who undertake a small number of revision KR procedures. To optimise patient outcomes and deliver cost-effective care high-volume revision knee surgeons working at high volume centres should undertake revision KR. This document outlines practice guidelines for units providing a revision KR service and sets out: The current landscape of revision KR in England, Wales and Northern Ireland. Service organisation within a network model. The necessary infrastructure required to provide a sustainable revision service. Outcome metrics and auditable standards. Financial mechanisms to support this service model.CONCLUSIONS Revision KR patients being treated in the NHS should be provided with the best care available. This report sets out a framework to both guide and support revision KR surgeons and centres to achieve this aim.

KW - Arthroplasty

KW - Guidelines

KW - Infection

KW - Knee

KW - Revision

U2 - 10.1016/j.knee.2021.01.032

DO - 10.1016/j.knee.2021.01.032

M3 - Article

C2 - 33690016

SN - 0968-0160

VL - 29

SP - 353

EP - 364

JO - The Knee

JF - The Knee

ER -

Revision knee replacement surgery in the NHS: a BASK surgical practice guideline

Abstract

Keywords

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