Fewer Adverse Events Following Outpatient Compared with Inpatient Unicompartmental Knee Arthroplasty

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Edward S. Hur ◽  
Joseph Serino ◽  
Daniel D. Bohl ◽  
Craig J. Della Valle ◽  
Tad L. Gerlinger
Keyword(s):  
Adverse Events ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Unicompartmental Knee

scholarly journals The Renaissance of Unicompartmental Knee Arthroplasty appears rational – A radiograph-based comparative Study on adverse Events and patient-reported Outcomes in 353 TKAs and 98 UKAs

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257233
Author(s):  
Magnus Tveit
Keyword(s):  
Adverse Events ◽  
Knee Arthroplasty ◽  
Complication Rate ◽  
Unicompartmental Knee Arthroplasty ◽  
Patient Reported Outcomes ◽  
Statistical Significance ◽  
Severe Complication ◽  
Unicompartmental Knee ◽  
Patient Reported ◽  
Reduced Risk

Purpose Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) are both considered suitable for antero-medial osteoarthritis and spontaneous osteonecrosis of the knee. National registry data are consistent in showing higher revision rates for UKA. Adequately adjusted, these findings may be challenged by differences in adverse events and patient-reported outcomes, as both can have serious long-term implications. Based on preoperative radiographs, the aim was to retrospectively compare the two principle surgeries in these respects. Methods All TKA procedures in 2016 in one Swedish county council were, according to certain radiograph-based consensus criteria, visually evaluated for medial UKA suitability. Then, using different regression models, they were compared with the corresponding medial UKAs performed in 2015–2017 regarding complications and patient-reported outcomes one year after surgery. Results The UKA group showed an 82% reduced risk (OR 0.2; 95% CI 0.0–0.6) of any complications, whereas the 55% reduced risk of severe complication did not reach statistical significance (OR 0.5; 95% CI 0.1–2.1). These findings corresponded in high-volume surgeries to an absolute complication rate of 0% in the UKA group and 10% in the TKA group (p = 0.005) and to a severe complication rate of 0% and 5% respectively (p = 0.05). Though no differences were seen in any general patient-reported outcomes, the pain and function based OMERACT-OARSI responder criteria indicated in both around a 60% better chance of any response (OR 1.6 CI % 0.6–4.5) and a high response (OR 1.6; 95% CI 0.7–3.4) in the UKA group. Conclusion No differences were shown in patient-reported outcomes but a clear difference in risk of complications, favoring the UKA procedure.

Hypoalbuminemia Predicts Adverse Events following Unicompartmental Knee Arthroplasty

2021 ◽  
Author(s):  
Edward S. Hur ◽  
Daniel D. Bohl ◽  
Craig J. Della Valle ◽  
Felipe Villalobos ◽  
Tad L. Gerlinger
Keyword(s):  
Adverse Events ◽  
Serum Albumin ◽  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Nutritional Deficiencies ◽  
Albumin Concentration ◽  
Serum Albumin Concentration ◽  
Improvement Program ◽  
Unicompartmental Knee ◽  
Preoperative Serum

AbstractHypoalbuminemia is a potentially modifiable risk factor associated with adverse events following total knee arthroplasty. The present study aimed to evaluate whether hypoalbuminemia similarly predisposes to adverse events following unicompartmental knee arthroplasty (UKA). Patients who underwent UKA during 2006–2018 were identified through the American College of Surgeons National Surgical Quality Improvement Program. Only patients with preoperative serum albumin concentration were included. Outcomes were compared between patients with and without hypoalbuminemia (serum albumin concentration < 3.5 g/dL). All associations were adjusted for demographic, comorbidity, and laboratory differences between populations. A total of 11,342 patients were identified, of whom 6,049 (53.3%) had preoperative serum albumin laboratory values available for analysis. After adjustment for potential confounders, patients with hypoalbuminemia had a greater than 2-fold increased probability for occurrence of any complication (7.02% vs. 2.23%, p = 0.009) and a 4-fold increased probability of receiving a blood transfusion (1.81% vs. 0.25%, p = 0.045). Among procedures performed as inpatients, mean postoperative length of stay (LOS) was longer in patients with hypoalbuminemia (2.2 vs. 1.8 days; p = 0.031). Hypoalbuminemia is independently associated with complications and increased LOS following UKA and a marker for patients at higher risk of postoperative complications. Patients should be screened for hypoalbuminemia and nutritional deficiencies addressed prior to UKA.

scholarly journals Good mid- to long-term results of the cemented oxford phase 3 unicompartmental knee arthroplasty in a non-designer centre

2021 ◽  
Author(s):  
D. M. Moore ◽  
G. A. Sheridan ◽  
A. Welch-Phillips ◽  
J. M. O’Byrne ◽  
P. Kenny
Keyword(s):  
Knee Arthroplasty ◽  
Unicompartmental Knee Arthroplasty ◽  
Womac Score ◽  
Long Term Results ◽  
Secondary Outcome ◽  
Osteoarthritis Of The Knee ◽  
Phase 3 ◽  
Unicompartmental Knee ◽  
Aseptic Revision

Abstract Purpose Unicompartmental knee arthroplasty (UKA) provides patients with an alternative treatment to TKA in isolated medial compartment osteoarthritis providing better functional outcomes and faster recovery in the short term. Our aim was to quantify revision rates, predictors of revision, mortality rate and functionality of the Oxford Phase 3 UKA in a non-designer institution. Methods This was a retrospective review of prospectively collected regional registry data. All Oxford Phase 3 UKAs performed for medial tibio-femoral osteoarthritis of the knee joint were included from a single academic institution between the period of January 1st 2006 and December 30th 2009. Kaplan-Meier survivorship curves adjusting for loss to follow-up and deceased patients were generated. Primary outcome variables included all-cause and aseptic revision. Secondary outcome variables included functional outcome scores. Patients were reviewed at 6 months, 2 years, 5 years, 10 years and 15 years. Results A total of 64 cemented Oxford phase 3 UKAs were performed between January 2006 and November 2009. Fifteen-year follow-up data were available for 51 patients, of these 12 required revision. Survival rates, adjusting for patients that were either lost to follow-up or deceased, were 87.5% at 5 years, 81.4% at 10 years and 76.4% at 15 years. The overall aseptic revision rate at the time of review was 18.75% (n = 12). The only significant predictor of postoperative WOMAC score at 15 years was the preoperative WOMAC score (p = 0.03). Conclusion The Oxford Phase 3 UKA for medial tibio-femoral arthritis has promising outcomes at 15-year follow-up with a survival rate of 76.4% in a non-designer centre. Level of Evidence III.

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