Knee Revision BOASTs

The BOA and BASK are pleased to publish new ‘Specialty BOASTs’ led by BASK on the following topics related to revision knee surgery:

• Revision Knee Replacement Surgical Practice Guidelines 
• Investigation and Management of Patients with Problematic Knee Replacements 
• Investigation and Management of Periprosthetic Knee Joint Infection in Knee Replacement

We would like to highlight that many BOA and BASK members will have been aware of a project that we were involved in with NHS E&I to establish knee revision networks across England to support the implementation of GIRFT recommendations. A new approach to payment for complex revision knee replacement surgery that the national NHS England specialised commissioning team had developed in conjunction with the NHS Pricing Team, was to be used as a national pilot project alongside the establishment of  coordinated network care pathways. This initiative was paused during the COVID-19 pandemic and has not restarted as yet, due to ongoing planning of the future financial architecture of NHS services in England.

We previously had intended to publish these BOASTs to coincide and support the NHSE&I revision knee networks project, and the BOASTs relate in part to the network set-up that was envisaged. We have decided to proceed with publishing them, because: (1) some aspects of the BOASTs are more general about the care of revision knee patients and not specific to networks and therefore can be applicable to all and (2) we know some regions have already or are considering setting up such networks and we hope this guidance will support them in this. We are aware that without the funding model that NHS E&I were due to introduce the establishment of regional networks and MDTs may not be possible in all areas.