Does knee cartilage repair surgery prevent arthritis or the need for a joint replacement?
In the UK, approximately 1/5 of over-45s have been diagnosed with osteoarthritis (OA), the knee being the most frequently affected joint. The cause of OA is unknown, but it develops when cartilage wears out. For example, knee injury in young adults can increase their risk of developing knee OA sixfold. There is also a genetic contribution to OA. OA is treated with physiotherapy, painkillers, surgery, or as a last resort, a joint replacement. Cartilage repair surgeries focus on stopping knee pain and improving function, but they may also slow OA. It’s important to measure outcomes following surgery to understand if they have helped the patient. Ideally, knee cartilage surgeries in middle-aged patients will slow down OA and delay or eliminate the need for joint replacement. We don’t know if this happens in real-time. We plan to work out the true effect of knee cartilage surgeries by studying health records from the UK Biobank to find out whether cartilage surgery can help patients with a higher genetic risk of OA onset. We will bring together several risk factors (e.g. patient characteristics, other disorders, cartilage surgery type and genetic risk score for OA) to create a tool (a phone app) for orthopaedic surgeons. They will use the tool in clinics to help fit cartilage treatment to their patients to delay or avoid the development of severe OA. It will help weigh up the benefits of surgery relative to risk. This will improve their quality of life and reduce the need for knee replacements, both of which represent health-economic benefits.
