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Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Few large-scale studies using adjusted data from national registries have explored the risk factors of subsequent revision in patients with unicompartmental knee arthroplasty (UKA) compared to those with total knee arthroplasty (TKA). We investigated the incidence rate and risk factors of subsequent revision in patients with UKA and TKA.

Methods

We enrolled all patients who had undergone TKA or UKA as the primary surgical procedure without histories of having undergone either procedure during the preceding 2 years. Matched Cox regression models were used to compare the risks of revision between groups after propensity score matching. Revision was defined as conversion to revision TKA after primary TKA and conversion to TKA after UKA.

Results

The study enrolled 418,806 TKA patients and 446,009 UKA patients. The risk of revision during the entire study period was higher for patients with UKA than for patients with TKA (adjusted hazard ratio [HR] 1.22, 95% confidence interval [95% CI]: 1.10–1.36). The Kaplan–Meier 8-year survival was 98.7% in the TKA group and 96.7% in the UKA group. Patients with UKA were at an increased risk of revision in cases of advanced age (70–79 years, HR 1.40, 95% CI: 1.15–1.71), female sex (HR 1.32, 95% CI: 1.16–1.49), the presence of chronic obstructive pulmonary disease (COPD) (HR 1.27, 95% CI: 1.05–1.54), the presence of peptic ulcer disease (PUD) (HR 1.34, 95% CI: 1.11–1.61) compared to patients with TKA. In patients with hemiplegia, however, UKA were associated with a lower risk of subsequent revision (HR 0.25, 95% CI: 0.07–0.94).

Conclusion

The risk of a complete exchange or failure was higher for patients with UKA than for patients with TKA. The most significant independent risk factors for subsequent a complete exchange or failure in patients with UKA were advanced age (70–79 years), female sex, and the presence of comorbidities such as COPD and PUD.

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Acknowledgements

The authors did not receive any outside funding or grants in support of their research for or preparation of this work. The authors would like to thank Mr. Kwang-Young Jung and Ms. Jae-Ok Park for them help in preparing the manuscript.

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Author notes

  1. Seung-Beom Han and Si-Young Song contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Seung-Beom Han

  2. Department of Orthopedic Surgery, Dongtan Sacred Heart Hospital, Hallym University School of Medicine, Hwaseong, Republic of Korea

    Si-Young Song

  3. Department of Orthopedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University School of Medicine, 77 Sakju-ro, Chuncheon-si, Gangwon-do, Chuncheon, 24253, Republic of Korea

    Jae-Hoon Shim & Young-Soo Shin

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  1. Seung-Beom Han
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Correspondence to Young-Soo Shin.

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Research of this study was performed at Chuncheon Sacred Heart hospital, Hallym University School of Medicine.

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Han, SB., Song, SY., Shim, JH. et al. Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea. Arch Orthop Trauma Surg 141, 477–488 (2021). https://doi.org/10.1007/s00402-020-03675-1

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  • DOI: https://doi.org/10.1007/s00402-020-03675-1

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