Comparison of two different approaches to knee replacement surgery

INTERVENTION: All patients recruited to the study will have a routine Total Knee Replacement as they would normally on the NHS in Weston General Hospital. On admission they will be randomised into one of the two study arms. This randomisation will be done by use of a random number generator and the outcome in a sealed envelope to be opened on the day of surgery. At this point the patient will enter either the curved incision or the straight incision arm of the trial. In the curved incision arm the patient will receive a curved medial para‐patellar incision for the knee replacement, and in the straight incision arm they will receive a straight midline incision. With the exception of the shape of the incision the rest of the operation will proceed as normal NHS care for a knee replacement. Postoperatively the wound healing will be assessed by measuring the wound ooze. This is assessed by measuring the amount of marking on the dressings each day using a validated method. The patient's satisfaction with the wound will be measured using a validated wound assessment tool at the 6 week post‐op review. This will be the extent of the follow‐up for the purpose of the study but this will be the usual follow‐up that the patient would receive normally, were they not in the study. CONDITION: Conditions requiring knee replacement ; Musculoskeletal Diseases ; Conditions requiring knee replacement PRIMARY OUTCOME: Wound ooze on day 1 to day 4, using graph paper printed onto acetate sheets which can by laid onto the dressing, allowing the size of dressing marking to be measured by counting the number of squares on the graph paper which are involved SECONDARY OUTCOME: ; 1. The length of inpatient stay (days) following the surgery; 2. Whether or not an expensive 'PICO' dressing is required (only if the patient has persistent wound ooze more than 2x2cm at day 4); 3. Patient satisfaction with the appearance and function of the scar as assessed by means of a validated wound scoring system, the Patient and Observer Scar Assessment Scale (POSAS) (the patient assessment part of this questionnaire) at week 4 and week 6 post‐operatively; INCLUSION CRITERIA: 1. Aged 18 years or older 2. Undergoing planned primary Total Knee Replacement surgery in Weston General Hospital