The St. Leger total knee replacement. A false economy?
We reviewed the outcome of 53 primary St. Leger total knee replacement (TKR) implanted into 47 patients over a 2-year period from March 1995 and compared the outcome with age and sex matched controls with the Kinemax Plus TKR. All operations were performed to treat osteoarthritis of the knee. The St. Leger replacements were done in a Teaching Hospital by a Consultant surgeon while the Kinemax Plus replacements were done in the same hospital by two other surgical teams. During the period of review, 13 patients (13 knees) with St. Legers died or were too demented to participate, and 4 were lost to follow up. Eleven patients (13 knees) with the Kinemax died or were too demented to cooperate, and 2 patients (2 knees) were lost to follow up. The St. Leger group had inferior Oxford Knee Scores to the Kinemax group but this was not significant. The St. Leger group had significantly worse survivorship of the prosthesis. The St. Leger prosthesis was cheaper (Pound sterling 650) than the Kinemax (Pound sterling 1150). The initial saving was dwarfed by the ultimate cost of revision procedures.
Westwood
Mark J
MJ
Trauma and Orthopaedics, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK. markwestwood@ukgateway.net
White
Simon P
SP
Bannister
Gordon C
GC
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000191:economics*; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D006801:Humans; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D012086:Reoperation / Q000191:economics; D016019:Survival Analysis; D016896:Treatment Outcome