Analysis of revision rates and complication rates among patients undergoing unicompartmental and bicompartmental knee Arthroplasties when compared to Total knee arthroplasty

Nov 27, 2022The Knee

Revision and complication rates after partial versus total knee replacement surgeries

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Abstract

The BKA cohort had higher odds of one and two-year revision compared to UKA and TKA cohorts.

Bicompartmental knee arthroplasty (BKA) showed the highest revision rates at one and two years post-surgery.
Unicompartmental knee arthroplasty (UKA) also had higher odds of revision compared to total knee arthroplasty (TKA), but lower odds of manipulation under anesthesia at one year.
Both BKA and UKA were associated with lower odds of any postoperative complications within 90 days compared to TKA.
Overall, medical complications were much less common across all partial knee replacement types compared to TKA.

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BACKGROUND: With recent advances in partial knee arthroplasty, there is conflicting data regarding the outcomes and revision rates for bicompartmental knee arthroplasty (BKA) and unicompartamental knee arthroplasty (UKA) compared to total knee arthroplasty (TKA). This study uses national data to compare surgical and medical complications of UKA, BKA, and TKA to aid surgical decision-making.

METHODS: A retrospective cohort analysis was done using the Mariner dataset of the PearlDiver patient records database from 2010-2019. Current Procedural Terminology (CPT) codes were used to identify patients who underwent UKA, BKA, and TKA for a primary indication of osteoarthritis (OA). Univariate and multivariable analyses were performed to determine 1-year and 2-year revision, prosthetic joint infection (PJI), and loosening, 1-year manipulation under anesthesia (MUA), and 90-day postoperative medical complications.

RESULTS: The BKA cohort was found to have higher odds of one and two-year revision compared to UKA and TKA cohorts. Additionally, the UKA cohort had higher odds of one and two-year revision but lower odds of 1-year MUA than the TKA cohort. However, both the BKA and UKA cohorts had lower odds of any 90-day postoperative complications when compared to the TKA cohort.

CONCLUSIONS: Even with modern implants and approaches, our study found that revision rates are highest for BKA followed by UKA and TKA at two years postoperatively. Notably, medical complications were much less common after all partial knee replacement types when compared to TKA. These findings may be used to guide patients in selecting the appropriate surgery to meet their goals and expectations.

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Analysis of revision rates and complication rates among patients undergoing unicompartmental and bicompartmental knee Arthroplasties when compared to Total knee arthroplasty

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