Summary

The KAT trial, funded by the NIHR HTA Programme is the largest randomised trial of knee replacement surgery ever undertaken, in which the effects of patellar resurfacing, mobile bearings and metal backing were investigated. A total of 116 surgeons in 34 UK centres participated and 2352 participants were randomised.  At a median of 10 years of follow-up we can be more than 95% confident that patella resurfacing is cost-effective, despite there being no significant difference in clinical outcomes.  We found no definite advantage or disadvantage of mobile bearings in OKS, quality of life, reoperation and revision rates or cost-effectiveness.  We found improved functional results for metal-backed tibias: complication, reoperation and revision rates were similar.  The metal-backed tibia was cost-effective, particularly in the elderly. 

The KAT trial is led by Professor David Murray based at the University of Oxford. 

Follow-up to 20 years post-randomisation is ongoing.

For more information please see the KAT Study WebsiteKat Trial Logo

Contact

Suzanne Breeman; s.breeman@abdn.ac.uk

Status

Data Collection - Follow Up

Publications

The Knee Arthroplasty Trial (KAT) design features, baseline characteristics, and two-year functional outcomes after alternative approaches to knee replacement. M Campbell, N Fiddian, R Fitzpatrick, A Grant, A Gray, R Morris, D Murray, D Rowley, L Johnston, G MacLennan, K McCormack, C Ramsay, A Walker:  J Bone Joint Surg Am, 2009;91(1):134-41

Patellar resurfacing in total knee replacement: five-year clinical and economic results of a large randomized controlled trial. Breeman S, Campbell M, Dakin H, Fiddian N, Fitzpatrick R, Grant A, Gray A, Johnston L, MacLennan G, Morris R, Murray D. J Bone Joint Surg Am, 2011; 93:1473-81

Five year results of a randomised controlled trial comparing mobile and fixed bearings in total knee replacement. Breeman S, Campbell M, Dakin H, Fiddian N, Fitzpatrick R, Grant A, Gray A, Johnston L, MacLennan G, Morris R, Murray D. J Bone Joint Surg Br, 2013;95(4):486-92

Murray DW, Maclennan GS, Breeman S, Dakin HA, Johnston L, Campbell MK, et al.A randomised controlled trial of the clinical effectiveness and cost-effectiveness of different knee prostheses: the Knee Arthroplasty Trial (KAT). Health Technol Assess 2014;18(19)