scholarly journals Pain management of unicompartmental (UKA) vs. total knee arthroplasty (TKA) based on a matched pair analysis of 4144 cases

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Günther Maderbacher ◽  
Florian Zeman ◽  
Winfried Meissner ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Pain Medication ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Pain Scores ◽  
Unicompartmental Knee ◽  
Total Knee ◽  
Pair Analysis

Abstract Unicompartmental knee arthroplasty and total knee arthroplasty are well established treatment options for end-stage osteoarthritis, UKA still remains infrequently used if you take all knee arthroplasties into account. An important factor following knee arthroplasty is pain control in the perioperative experience, as high postoperative pain level is associated with persistent postsurgical pain. There is little literature which describes pain values and the need for pain medication following UKA and/or TKA. So far, no significant difference in pain has been found between UKA and TKA. The aim of the study was to evaluate differences in the postoperative course in unicompartmental knee arthroplasty vs. total knee arthroplasty regarding the need for pain medication and patient-reported outcomes including pain scores and side effects. We hypothesized that unicompartmental knee arthroplasty is superior to total knee arthroplasty in terms of postoperative pain values and the need of pain medication. In this project, we evaluated 2117 patients who had unicompartmental knee arthroplasty and 3798 who had total knee arthroplasty performed, from 2015 to 2018. A total of 4144 patients could be compared after performing the matched pair analysis. A professional team was used for data collection and short patient interviews to achieve high data quality on the first postoperative day. Parameters were compared after performing a 1:1 matched pair analysis, multicenter-wide in 14 orthopedic departments. Pain scores were significantly lower for the UKA group than those of the TKA group (p < 0.001 respectively for activity pain, minimum and maximum pain). In the recovery unit, there was less need for pain medication in patients with UKA (p = 0.004 for non-opioids). The opiate consumption was similarly lower for the UKA group, but not statistically significant (p = 0.15). In the ward, the UKA group needed less opioids (p < 0.001). Patient subjective parameters were significantly better for UKA. After implantation of unicompartmental knee arthroplasty, patients showed lower pain scores, a reduced need for pain medication and better patient subjective parameters in the early postoperative course in this study.

Clinical Outcomes of a Modern Total Knee Arthroplasty Prosthesis Compared to Its Predecessor at 5-Year Follow-Up: Matched Pair Analysis

2020 ◽  
Vol 35 (11) ◽  
pp. 3150-3155
Author(s):  
Peter B. White ◽  
Sava Turcan ◽  
James R. Satalich ◽  
Amar S. Ranawat ◽  
Chitranjan S. Ranawat
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Total Knee ◽  
Pair Analysis

All-polyethylene and metal-backed tibial components in total knee arthroplasty: a matched pair analysis of functional outcome

2003 ◽  
Vol 18 ◽  
pp. 9-15 ◽  
Author(s):  
Soheil Najibi ◽  
Richard Iorio ◽  
Jonathan W Surdam ◽  
William Whang ◽  
David Appleby ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Matched Pair ◽  
Matched Pair Analysis ◽  
Total Knee ◽  
Pair Analysis

scholarly journals Posterior-stabilized total knee arthroplasty: a matched pair analysis of a classic and its evolutional design

2016 ◽  
Vol 2 (4) ◽  
pp. 193-198 ◽  
Author(s):  
Pier Francesco Indelli ◽  
Gennaro Pipino ◽  
Paul Johnson ◽  
Angelo Graceffa ◽  
Massimiliano Marcucci
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Matched Pair ◽  
Posterior Stabilized ◽  
Matched Pair Analysis ◽  
Total Knee ◽  
Pair Analysis

scholarly journals High usage of medial unicompartmental knee arthroplasty negatively influences total knee arthroplasty revision rate

2021 ◽  
Author(s):  
Antonio Klasan ◽  
Mei Lin Tay ◽  
Chris Frampton ◽  
Simon William Young
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Revision Rate ◽  
Oxford Knee Score ◽  
High Volume ◽  
Unicompartmental Knee ◽  
Patient Reported ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Total Knee

Abstract Purpose Surgeons with higher medial unicompartmental knee arthroplasty (UKA) usage have lower UKA revision rates. However, an increase in UKA usage may cause a decrease of total knee arthroplasty (TKA) usage. The purpose of this study was to investigate the influence of UKA usage on revision rates and patient-reported outcomes (PROMs) of UKA, TKA, and combined UKA + TKA results. Methods Using the New Zealand Registry Database, surgeons were divided into six groups based on their medial UKA usage: < 1%, 1–5%, 5–10%, 10–20%, 20–30% and > 30%. A comparison of UKA, TKA and UKA + TKA revision rates and PROMs using the Oxford Knee Score (OKS) was performed. Results A total of 91,895 knee arthroplasties were identified, of which 8,271 were UKA (9.0%). Surgeons with higher UKA usage had lower UKA revision rates, but higher TKA revision rates. The lowest TKA and combined UKA + TKA revision rates were observed for surgeons performing 1–5% UKA, compared to the highest TKA and UKA + TKA revision rates which were seen for surgeons using > 30% UKA (p < 0.001 TKA; p < 0.001 UKA + TKA). No clinically important differences in UKA + TKA OKS scores were seen between UKA usage groups at 6 months, 5 years, or 10 years. Conclusion Surgeons with higher medial UKA usage have lower UKA revision rates; however, this comes at the cost of a higher combined UKA + TKA revision rate that is proportionate to the UKA usage. There was no difference in TKA + UKA OKS scores between UKA usage groups. A small increase in TKA revision rate was observed for high-volume UKA users (> 30%), when compared to other UKA usage clusters. A significant decrease in UKA revision rate observed in high-volume UKA surgeons offsets the slight increase in TKA revision rate, suggesting that UKA should be performed by specialist UKA surgeons. Level of evidence III, Retrospective therapeutic study.

Matched-Pair Analysis of Local Infiltration Analgesia in Total Knee Arthroplasty: Patient Satisfaction and Perioperative Pain Management in 846 Cases

2018 ◽  
Vol 32 (10) ◽  
pp. 953-959 ◽  
Author(s):  
Felix Greimel ◽  
Günther Maderbacher ◽  
Clemens Baier ◽  
Timo Schwarz ◽  
Florian Zeman ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Pain Management ◽  
Knee Arthroplasty ◽  
Postoperative Pain Management ◽  
Matched Pair ◽  
Local Infiltration Analgesia ◽  
Replacement Surgery ◽  
Matched Pair Analysis ◽  
Total Knee ◽  
Pair Analysis

AbstractIn the recent past, numerous studies evaluating local infiltration analgesia (LIA) with controversial results have been reported. Efforts have been made to improve patients' outcome regarding operation techniques and material, as well as pain management and anesthetic methods. In this study, postoperative pain management and patient satisfaction were evaluated in patients undergoing total knee replacement surgery with or without intraoperative LIA. Within the context of the “Quality Improvement in Postoperative Pain Management” (QUIPS) project, parameters were collected on the first postoperative day. All patients included in this study underwent primary knee replacement surgery with general anesthesia. Parameters were compared after performing a 1:1 matched-pair analysis within 14 orthopaedic departments. Pain levels and pain management satisfaction were measured using the numerous rating scales, and pain medication use was compared. From 2010 to 2015, 2,789 patients who underwent primary knee arthroplasty with general anesthesia were evaluated within the project, of whom a total of 846 patients could be compared after performing a matched-pair analysis. Pain scores were significantly better in the LIA group (p = 0.019 for activity pain, p = 0.043 for maximum pain, p < 0.001 for minimum pain), but pain management satisfaction was not superior (p = 0.083). Patients with LIA required less opioids in the recovery room (p = 0.048), while nonopioid medication did not differ significantly (p = 0.603). At the ward, 24 hours postoperatively, no significant difference in the use for nonopioids (p = 0.789) could be measured, whereas patients in the LIA group received significantly more opioids (p < 0.001). Although LIA achieved improvement in pain score outcome, and a comparable patient satisfaction level in the immediate postoperative course, the use of LIA in knee arthroplasty, controversially discussed in the current literature, was not able to reduce the need for opioid pain medication in this study.

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