An Analysis of Risk Factors for Short-Term Complication Rates and Increased Length of Stay Following Unicompartmental Knee Arthroplasty
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Unicompartmental knee arthroplasty (UKA) is an increasingly popular procedure, with excellent long-term outcomes. However, there are only a limited number of reports reporting its short-term morbidity and mortality.
We sought to analyze the reported 30-day morbidity, mortality, and risk factors for complications and prolonged length of stay (>4 days) following UKA.
Patients and Methods
Utilizing the National Surgical Quality Improvement Program (NSQIP) database, including patients (n = 2316) from 2005–2012, we correlated the reported 30-day complications and prolonged length of stay with patient demographics and risk factors.
The overall rate of complications was low (3.2%). The distribution of complications demonstrated 0.5% major systemic, 1.4% minor systemic, 0.7% major local, and 0.9% minor local complications, with a 2.1% readmission rate. Multivariate regression demonstrated increased BMI and a history of chronic obstructive pulmonary disease (COPD) as independent risk factors for complications. Furthermore, multivariate regression demonstrated increased BMI, ASA ≥ 3, history of COPD, recent operation, and postoperative transfusion as independent risk factors for prolonged length of hospitalization.
Utilizing the NSQIP, we present one of the largest studies to date evaluating complications following UKA. Our multivariate model demonstrated obesity and COPD to be the risk factors for complications while obesity, ASA ≥ 3, COPD, recent operation, and blood transfusion to be the risk factors for prolonged length of stay.
KeywordsUnicompartmental Knee Arthroplasty NSQIP Short-Term Complications COPD Obesity Transfusion
Conflict of Interest
Bryan D. Haughom, MD, William W. Schairer, MD, Michael D. Hellman, MD, Benedict U. Nwachukwu, MD and Brett R. Levine, MD, MS have declared that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).
Informed consent was waived from all patients for being included in the study.
Required Author Forms
Disclosure forms provided by the authors are available with the online version of this article.
- 1.American college of surgeons website. Available at: http://site.acsnsqip.org. Accessed December 18, 2013
- 2.Amin AK, Patton JT, Cook RE, Gaston M, Brenkel IJ. Unicompartmental or total knee arthroplasty?: Results from a matched study. Clin Orthop Relat Res. 2006; 101–106.Google Scholar
- 3.Argenson JN, Parratte S, Ashour A, Saintmard B, Aubaniac JM. The outcome of rotating-platform total knee arthroplasty with cement at a minimum of ten years of follow-up. J Bone Joint Surg Am. 2012; 7: 638-644.Google Scholar
- 12.Data use agreement for the american college of surgeons national surgical quality improvement program. Available at: http://site.acsnsqip.org/participant-use-data-file/. Accessed December 19, 2013.
- 13.Davenport DL, Holsapple CW, Conigliaro J. Assessing surgical quality using administrative and clinical data sets: A direct comparison of the university HealthSystem consortium clinical database and the national surgical quality improvement program data set. Am J Med Qual. 2009; 5: 395-402.CrossRefGoogle Scholar
- 15.Fisher DA, Dalury DF, Adams MJ, Shipps MR, Davis K. Unicompartmental and total knee arthroplasty in the over 70 population. Orthopedics. 2010;9:668-20100722-05.Google Scholar
- 17.Hernigou P, Deschamps G. Patellar impingement following unicompartmental arthroplasty. J Bone Joint Surg Am. 2002; 7: 1132-1137.Google Scholar
- 19.Kim YH, Kim JS, Choe JW, Kim HJ. Long-term comparison of fixed-bearing and mobile-bearing total knee replacements in patients younger than fifty-one years of age with osteoarthritis. J Bone Joint Surg Am. 2012; 10: 866-873.Google Scholar
- 20.Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: A follow-up study of 50,493 knee replacements from the finnish arthroplasty register. Acta Orthop. 2008; 4: 499-507.CrossRefGoogle Scholar
- 28.Niinimaki T, Eskelinen A, Makela K, Ohtonen P, Puhto AP, Remes V. Unicompartmental knee arthroplasty survivorship is lower than TKA survivorship: A 27-year finnish registry study. Clin Orthop Relat Res. 2013.Google Scholar
- 30.O’Rourke MR, Gardner JJ, Callaghan JJ, et al. The john insall award: Unicompartmental knee replacement: A minimum twenty-one-year followup, end-result study. Clin Orthop Relat Res. 2005; 27–37.Google Scholar
- 36.Yang KY, Wang MC, Yeo SJ, Lo NN. Minimally invasive unicondylar versus total condylar knee arthroplasty–early results of a matched-pair comparison. Singapore Med J. 2003; 11: 559-562.Google Scholar