Bias and unicompartmental knee arthroplasty
File(s)
Accepted version
Author(s)
Murray, DW
Liddle, AD
Judge, A
Pandit, H
Type
Journal Article
Abstract
We recently published a paper comparing the incidence of adverse outcomes after unicompartmental and total knee arthroplasty (UKA and TKA). The conclusion of this study, which was in favour of UKA, was dismissed as “biased” in a review in Bone & Joint 360.
Although this study is one of the least biased comparisons of UKA and TKA, this episode highlights the biases that exist both for and against UKA. In this review, we explore the different types of bias, particularly selection, reporting and measurement. We conclude that comparisons between UKA and TKA are open to bias. These biases can be so marked, particularly in comparisons based just on national registry data, that the conclusions can be misleading. For a fair comparison, data from randomised studies or well-matched, prospective observational cohort studies, which include registry data, are required, and multiple outcome measures should be used. The data of this type that already exist suggest that if UKA is used appropriately, compared with TKA, its advantages outweigh its disadvantages.
Although this study is one of the least biased comparisons of UKA and TKA, this episode highlights the biases that exist both for and against UKA. In this review, we explore the different types of bias, particularly selection, reporting and measurement. We conclude that comparisons between UKA and TKA are open to bias. These biases can be so marked, particularly in comparisons based just on national registry data, that the conclusions can be misleading. For a fair comparison, data from randomised studies or well-matched, prospective observational cohort studies, which include registry data, are required, and multiple outcome measures should be used. The data of this type that already exist suggest that if UKA is used appropriately, compared with TKA, its advantages outweigh its disadvantages.
Date Issued
2017-01-01
Date Acceptance
2017-01-01
Citation
Bone and Joint Journal, 2017, 99-B (1), pp.12-15
ISSN
2049-4394
Publisher
British Editorial Society of Bone and Joint Surgery
Start Page
12
End Page
15
Journal / Book Title
Bone and Joint Journal
Volume
99-B
Issue
1
Copyright Statement
© 2017, The British Editorial Society of Bone and Joint Surgery: All rights reserved.
Sponsor
Royal College of Surgeons of England
Arthritis Research UK
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000393669400004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
Royal College of Surgeons of England
Arthritis Research UK
Subjects
Science & Technology
Life Sciences & Biomedicine
Orthopedics
Surgery
NATIONAL JOINT REGISTRY
RANDOMIZED CONTROLLED-TRIAL
MATCHED PATIENTS
REPLACEMENT
ENGLAND
WALES
UNICONDYLAR
OUTCOMES
UK
Publication Status
Published
Date Publish Online
2017-01-01