LLR Policy for Knee Resurfacing

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Threshold Criteria

Knee Resurfacing (also known as Partial Knee Resurfacing, Partial Knee Replacement (PKR)) retains the healthy compartments of the knee joint and only replaces the damaged surfaces. Resurfacing may be an option if the arthritic deterioration of the knee is limited to only one or two of the compartments of the knee.


LLR ICB will only fund this procedure when the following criteria are met.
The patient has been assessed by Musculoskeletal Services and diagnosed as suffering from end-stage osteoarthritis suitable for referral for consideration of surgery,

The patient has fully engaged with conservative measures for a period of at least six months (clearly detailed throughout the patient’s primary care record or via Musculoskeletal Services’ clinic letters), as detailed within this policy, and this has failed to improve the symptoms of the patient,

The patient:
– Is suffering from intense or severe persistent pain with moderate or severe functional impairment when compared to the classification system on the previous page.

Has significant instability of the knee joint with significant functional impairment*,

Has radiological features of severe disease with moderate functional impairments;

Has radiological features of moderate disease with significant functional impairment* or instability of the knee joint and is suffering from


The patient has severe persistent pain that is causing severe functional impairment which is compromising their mobility to such an extent that they are in immediate danger of losing their independence and joint replacement would relieve this, and conservative management as set out in this policy is contra-indicated.

The patient is at risk of destruction of their joint of such severity that delaying surgical correction would increase the technical difficulties of the procedure.

*Significant functional impairment is defined as:
– Symptoms preventing the patient fulfilling routine work or educational responsibilities
– Symptoms preventing the patient carrying out routine domestic or carer activities

ARP 60 Review Date:2026

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