Revision Unicompartmental Knee Arthroplasty: Worse Than a Primary, But Better Than a Revision Total Knee Arthroplasty.

IF 3.4 2区 医学 Q1 ORTHOPEDICS
Enrico M Forlenza, Robert A Burnett, Alexander J Acuña, Brett R Levine, Jeremy M Gililland, Craig J Della Valle
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引用次数: 0

Abstract

Background: Revision of a unicompartmental to a total knee arthroplasty (TKA) is often compared to primary TKA with regard to its technical difficulty and complication rates. We sought to compare medical and surgical complications following revision unicompartmental knee arthroplasty (UKA) to those following primary TKA and aseptic revision TKA.

Methods: A national administrative claims database was queried for patients undergoing revision UKA between 2010 and 2019. Patients undergoing revision of a UKA were matched to patients undergoing primary TKA and aseptic revision TKA based on age, sex, Elixhauser Comorbidity Index (ECI), payor status, and a history of obesity, osteoporosis, tobacco use, and alcohol use disorder. Revision-free survivorship as well as 2-year and 90-day complication rates were compared. Multivariable logistic regression analysis was performed to determine the independent risk of medical and surgical complications.

Results: A total of 3,924 matched primary TKA, revision of a failed UKA, and aseptic revision TKA patients were included. Overall survivorship was 96.9% (95% CI [confidence interval] 95.9 to 97.8%) for primary TKA, 93.4% (95% CI 92.1 to 94.8%) for revision UKA, and 89.8% (95% CI 88.2 to 91.5%) for aseptic revision TKA at 2-year follow-up (P < 0.001). At two years, revision UKA patients had higher rates of aseptic loosening (2.2 versus 0.8%, P = 0.004), instability (2.4 versus 0.8%, P = 0.002), and mechanical failures (3.0 versus 1.5%, P = 0.012) than primary TKA patients. The 90-day complication rates were comparable between primary TKA and revision UKA patients (all P > 0.05); the risk of reoperation, acute kidney injury, wound dehiscence, hematoma, and transfusion were all higher in the revision TKA than in the revision UKA cohort (all P < 0.05).

Conclusion: Revision-free survivorship and arthroplasty-related complications at two years following revision UKA are lower than for primary TKA, but higher than for aseptic revision TKA, while medical complications are similar to those following primary TKA.

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来源期刊
Journal of Arthroplasty
Journal of Arthroplasty 医学-整形外科
CiteScore
7.00
自引率
20.00%
发文量
734
审稿时长
48 days
期刊介绍: The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.
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