Significant Reduction in Short-Term Complications Following Unicompartmental Versus Total Knee Arthroplasty: A Propensity Score Matched Analysis

O’Neill, Conor N.; Gowd, Anirudh K.; Waterman, Brian R.; Kates, Stephen L.; Patel, Nirav K.

doi:10.1016/j.arth.2022.04.032

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…Overall, our results confirm their findings that there is no difference in short term outcomes in the treatment of closed tibial shaft fracture following ORIF or IMN. There is an additional study using NSQIP database with regards to outcomes following UKA vs TKA [ 20 ], which could be used in addition for NSQIP quality metrics.…”

Section: Discussionmentioning

confidence: 99%

No Difference in Short-Term Complications following Treatment of Closed Tibial Shaft Fractures with Intramedullary Nailing versus Plate Fixation

O’Neill,

Hooper,

Wait

et al. 2023

Advances in Orthopedics

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Objectives. Tibial shaft fractures are treated with both intramedullary nailing (IMN) and plate fixation (ORIF). Using a large national database, we aimed to explore the differences in thirty-day complication rates between IMN and ORIF. Methods. Patients in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database who had undergone either tibial IMN or ORIF for closed fractures from 2010 to 2018 were identified using current procedural terminology (CPT) codes. After excluding all patients with open fractures, the propensity score was matching. Univariate and multivariate logistic regressions were used to identify risk factors associated with the thirty-day incidence of complications in the two cohorts. Results. A total of 5,400 patients were identified with 3,902 (72.3%) undergoing IMN and 1,498 (27.7%) ORIF. After excluding any ICD-10 diagnosis codes not pertaining to closed, traumatic tibial shaft fractures, 2,136 IMN and 621 ORIF cases remained. After matching, the baseline demographics were not significantly different between the cohorts. Following matching, the rate of any adverse event (aae) did not differ significantly between the IMN (7.08% (n = 44)) and ORIF (8.86% (n = 55)) cohorts ( p = 0.13 ). There was also no significant difference in operative time (IMN = 98.5 min, ORIF = 100 min; p = 0.3 ) or length of stay (IMN = 3.7 days, ORIF = 3.3 days; p = 0.08 ) between the cohorts. Conclusion. There were no significant differences in short-term complications between cohorts. These are important data for the surgeon when considering surgical management of closed tibial shaft fractures.

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Section: Discussionmentioning

confidence: 99%

No Difference in Short-Term Complications following Treatment of Closed Tibial Shaft Fractures with Intramedullary Nailing versus Plate Fixation

O’Neill,

Hooper,

Wait

et al. 2023

Advances in Orthopedics

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“…Unicompartmental knee replacement (UKR) is generally not recommended in the presence of concomitant anterior cruciate ligament (ACL) deficiency, and traditionally, total knee replacement (TKR) has been safely done in this setting [2]. However, considering these surgical options, UKR has advantages over TKR, including less invasiveness, lower blood loss, bone stock preservation, a quicker recovery, and improved joint kinematics [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Unicompartmental knee replacement combined with anterior cruciate ligament reconstruction provides comparable results to total knee replacement with no increased risk of complications

Legnani,

Borgo,

Macchi

et al. 2024

SICOT-J

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Introduction: There is controversy about the management of unicompartmental knee osteoarthritis (OA) in young, active patients with anterior cruciate ligament (ACL) insufficiency. This study compares the subjective, radiological, and functional results of total knee replacement (TKR) vs. combined medial unicompartmental knee replacement (UKR) with ACL reconstruction. Method: Twelve patients suffering from medial OA and ACL deficiency with varus knee deformity and/or tibial slope <10° and absence of patellofemoral-related problems were eligible for combined UKR and ACL reconstruction (Group A). Twenty-six patients matched for age, male/female ratio and body mass index who received TKR in the same time frame were included as a control group (Group B). Oxford Knee Score (OKS), WOMAC index of osteoarthritis, Knee Osteoarthritis Outcome Score (KOOS), and routine X-rays were used for assessment. Results: Ten years after surgery, the mean overall KOOS score, OKS, WOMAC index increased from preoperatively, showing a statistically significant difference (p < 0.001). In terms of KOOS, OKS, or WOMAC scores at the most recent follow-up, there was no discernible difference between the groups (p = n.s.). Three years following surgery, one female patient in group A received revision TKR due to the lateral compartment’s osteoarthritis developing and the patient’s pain persisting. Concerning radiographic assessment, at the most recent follow-up (average 7.9 years in group A and 8.8 years in group B), there were no radiographic indications of implant loosening or proof of pathologic radiolucent lines. Conclusions: UKR combined with ACL restoration offers clinical and radiographic outcomes comparable to TKR 10 years following surgery with no elevated risk of complications.

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“…Unicompartmental knee arthroplasty (UKA) can represent an alternative to total knee arthroplasty (TKA) for older patients (aged 80 years and older) with medial unicompartmental osteoarthritis (OA) of the knee [ 10 ]. Following TKA, older patients may have higher rates of medical and surgical complications than younger patients (< 65 years) due to more associated comorbidities and a lower tolerance for hemodynamic alterations [ 30 ]. UKA has been proven to have less problems than TKA when carried out on carefully chosen patients to restore knee kinematics and overall function more effectively [ 20 , 31 ], and it is also less expensive [ 34 , 36 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes, complications, and survivorship for unicompartmental knee arthroplasty versus total knee arthroplasty in patients aged 80 years and older with isolated medial knee osteoarthritis: a matched cohort analysis

D’Ambrosi

Ursino

Mariani

et al. 2023

Arch Orthop Trauma Surg

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Purpose The primary goal of this study is to compare clinical outcomes, complication rate, and survivorship in octogenarians who underwent total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA) by performing a matched cohort analysis. Methods We analyzed 75 medial UKAs performed by a single experienced surgeon. The included cases were matched with 75 TKAs performed during the same study period. Potential TKA matches used identical exclusion criteria. UKAs were age-, gender-, and body mass index (BMI)-matched at the rate of 1 UKA to 1 TKA from our departmental database. Clinical evaluation included the visual analog scale for pain, range of motion (ROM—flexion and extension), Knee Society Score (KSS), and Oxford Knee Score (OKS). Each patient was clinically evaluated on the day before the surgery (T0) and at two follow-ups at least 12 months (T1) and 24 months (T2) after the surgery. For the survivorship, revision was defined as failure of the implant (periprosthetic joint infection, periprosthetic fracture, or aseptic loosening), and survival was based on implant revision or patient death. Undesirable clinical developments that were not present at baseline or that increased in severity after treatment were classified as adverse events. Results The mean age at the time of the surgery was 82.1 ± 1.9 years for UKA and 81.5 ± 1.8 years for TKA (p = 0.06). The two groups differed in regard to surgical time (UKA 44.9 ± 7.2 min; TKA 54.4 ± 11.3 min; p < 0.001); furthermore, the UKA group showed better function (ROM; flexion and extension) than the TKA group at each follow-up time point (p < 0.05). Both groups reported a significant improvement in all clinical scores (KSS and OKS) when compared with their preoperative status (p < 0.05), while no differences were found between the groups at each follow-up (p > 0.05). The UKA group reported 7 (9.3%) failures, while TKA reported 6 failures. There were no survival differences between the groups (T1: p = 0.2; T2: p = 0.5). Overall complication rate was 6% in the UKA group versus 9.75% in TKA (p = 0.2). Conclusion The UKA and TKA patients had similar clinical outcomes, post-operative range of motion, and survivorship in octogenarians with medial knee osteoarthritis, with comparable complication rate. Both the surgical procedures may be considered in this patient population, but further long-term follow-up is needed. Level of evidence Level III.

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Significant Reduction in Short-Term Complications Following Unicompartmental Versus Total Knee Arthroplasty: A Propensity Score Matched Analysis

Cited by 4 publications

References 36 publications

No Difference in Short-Term Complications following Treatment of Closed Tibial Shaft Fractures with Intramedullary Nailing versus Plate Fixation

No Difference in Short-Term Complications following Treatment of Closed Tibial Shaft Fractures with Intramedullary Nailing versus Plate Fixation

Unicompartmental knee replacement combined with anterior cruciate ligament reconstruction provides comparable results to total knee replacement with no increased risk of complications

Clinical outcomes, complications, and survivorship for unicompartmental knee arthroplasty versus total knee arthroplasty in patients aged 80 years and older with isolated medial knee osteoarthritis: a matched cohort analysis

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