Journal article
Optimized medial unicompartmental knee arthroplasty outcome: learning from 20 years of propensity score matched registry data
- Abstract:
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Background and purpose: Unicompartmental knee arthroplasty (UKA) has increased in use. We investigated changes to UKA revision risk over the last 20 years compared with total knee arthroplasty (TKA), examined external and patient factors for correlation to UKA revision risk, and described the survival probability for current UKA and TKA practice.
Patients and methods: All knee arthroplasties reported to the Danish Knee Arthroplasty Register from 1997 to 2017 were linked to the National Patient Register and the Civil Registration System for comorbidity, emigration, and mortality information. All primary UKA and TKA patients with primary osteoarthritis were included and propensity score matched 4 TKAs to 1 UKA. Revision and mortality were analyzed using competing risk cox regression with a shared gamma frailty component.
Results: The matched cohort included 48,195 primary knee arthroplasties (9,639 UKAs). From 1997–2001 to 2012–2017 the 3-year hazard ratio decreased from 5.5 (95% CI 2.7–11) to 1.5 (CI 1.2–1.8) due to increased UKA survival. Cementless fixation, a high percentage usage of UKA, and increased surgical volume decreased UKA revision risk, and increased in occurrence parallel to the decreasing revision risks. Current UKA practice using cementless fixation at a high usage unit has a 3-year implant survival of 96% (CI 97–95), 1.1% lower than current TKA practice.
Interpretation: UKA revision risk has decreased over the last 20 years, nearing that of TKA surgery. High usage rates, surgical volume, and the use of cementless fixation have increased during the study and were associated with decreased UKA revision risks.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 1.2MB, Terms of use)
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- Publisher copy:
- 10.2340/17453674.2022.2265
Authors
- Publisher:
- Nordic Orthopaedic Federation
- Journal:
- Acta Orthopaedica More from this journal
- Volume:
- 93
- Pages:
- 390-396
- Publication date:
- 2022-04-06
- DOI:
- EISSN:
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1745-3682
- ISSN:
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1745-3674
- Pmid:
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35383856
- Language:
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English
- Keywords:
- Pubs id:
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1250728
- Local pid:
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pubs:1250728
- Deposit date:
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2022-07-14
Terms of use
- Copyright holder:
- Mikkelsen et al
- Copyright date:
- 2022
- Rights statement:
- © 2022 Mette Mikkelsen, Andrew Price, Alma Becic Pedersen, Kirill Gromov, Anders Troelsen. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
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