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Total Knee Arthroplasty Has Higher Postoperative Morbidity Than Unicompartmental Knee Arthroplasty: A Multicenter Analysis

      Abstract

      A total of 2235 primary total knee arthroplasties (TKAs) and 605 unicompartmental knee arthroplasties performed at 3 institutions over 5 years were reviewed to compare the incidence of postoperative complications between these groups. The overall risk of complications for patients undergoing TKA was 11.0%, compared with 4.3% for patients undergoing unicompartmental knee arthroplasty (P < .0001). Total knee arthroplasty was associated with increased rates of manipulation (odds ratio [OR], 13.0; P < .0001), transfusion (OR, 8.5; P = .036), intensive care unit admission (OR, 7.4; P = .049), discharge to a rehabilitation facility (OR, 5.2; P < .0001) and had longer hospital stays (mean, 3.3 vs 2.0 days; P < .0001). There was a trend toward an increased risk of deep infection (0.8% vs 0.2%, P = .13), readmission (4.2% vs 2.7%, P = .0795), thromboembolic events (1.0% vs 0.64%, P = .398), and any reoperation (1.4% vs 0.6%; P = .064). The increased risk of perioperative complications after TKA should be considered when counseling patients if they are an appropriate candidate for either procedure.

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      References

      1. Labek G, Revision rates after total joint replacement: cumulative results from worldwide joint register datasets. 93:3, 2011.

        • Ma H.M.
        Long-term results of total condylar knee arthroplasty.
        J Arthroplasty. 2005; 20: 5
        • Ranawat C.S.
        Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study.
        Clin Orthop Relat Res. 1993; : 286
        • Ritter MAMeneghini R.M.
        Twenty-year survivorship of cementless anatomic graduated component total knee arthroplasty.
        J Arthroplasty. 2010; 25: 4
      2. Amin AK, Unicompartmental or total knee arthroplasty?: Results from a matched study. 451:2006.

        • Laurencin C.T.
        Unicompartmental versus total knee arthroplasty in the same patient. A comparative study.
        Clin Orthop Relat Res. 1991; : 273
      3. Newman JH, Unicompartmental or total knee replacement? Five-year results of a prospective, randomised trial of 102 osteoarthritic knees with unicompartmental arthritis. 80:5, 1998.

      4. Yang KY, Minimally invasive unicondylar versus total condylar knee arthroplasty—early results of a matched-pair comparison. 44:11, 2003.

      5. Fisher DA, Unicompartmental and total knee arthroplasty in the over 70 population. 33:9, 2010.

        • Lombardi Jr, A.V.
        Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty?.
        Clin Orthop Relat Res. 2009; 467: 6
        • Ackroyd C.E.
        A comparative study of the medial St Georg sled and kinematic total knee arthroplasties.
        Ten-year survivorship. 2002; 84: 5
      6. Berger RA, Results of unicompartmental knee arthroplasty at a minimum of ten years of follow-up. 87:5, 2005.

        • Murray D.W.
        The Oxford medial unicompartmental arthroplasty: a ten-year survival study.
        J Bone Joint Surg Br. 1998; 80: 6
      7. Chtain F, Revision total knee arthroplasty after unicompartmental femorotibial prosthesis: 54 cases. 90:1, 2004.

      8. Hang J, Outcome of revision of unicompartmental knee replacement. 81:1, 2010.

        • Jrvenp J.
        The clinical outcome of revision knee replacement after unicompartmental knee arthroplasty versus primary total knee arthroplasty: 8-17 years follow-up study of 49 patients.
        Int Orthop. 2010; 34: 5
        • Oduwole K.O.
        Analysis of revision procedures for failed unicondylar knee replacement.
        Ir J Med Sci. 2010; 179: 3
      9. Robertsson O, Use of unicompartmental instead of tricompartmental prostheses for unicompartmental arthrosis in the knee is a cost-effective alternative. 15,437 primary tricompartmental prostheses were compared with 10,624 primary medial or lateral unicompartmental prostheses. 70:2, 1999.

      10. LA V., Jr, Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? 467:6, 2009.

      11. Kozinn SC, Scott R, Unicondylar knee arthroplasty. 71:1, 1989.

      12. Pandit H, The Oxford medial unicompartmental knee replacement using a minimally-invasive approach. 88:1, 2006.

      13. Charlson ME, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. 40:5, 1987.

      14. Dauty M, Which factors affect the duration of inpatient rehabilitation after total knee arthroplasty in the absence of complications? 52:3, 2009.