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Mortality and morbidity lower with unicompartmental than total knee replacement
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Compared with patients who underwent total knee replacement (TKR), patients who underwent unicompartmental knee replacement (UKR) had a significantly lower risk of death and complications, according to study results.
Researchers compared matched patients undergoing TKR and UKR in the National Joint Registry for England and Wales and linked data for multiple potential confounders from the National Health Service Hospital Episode Statistics database. Regression models were used to compare outcomes.
On the basis of propensity score, researchers matched 25,334 UKRs to 75,996 TKRs. Study results showed that the mortality was significantly less both in the short term and long term among patients who underwent UKRs vs. TKRs. At 30 days, the death rate was 4 times higher with TKR and at 8 years it was 13% higher. The incidence of complications, including major medical complications, such as myocardial infarction, stroke, thromboembolism and deep infection, was also about twice as high after TKR. Additionally, length of stay and rate of readmission were higher among patients who underwent TKR. However at 8 years, there was a better implant survival for both revision and revision/reoperation among patients who underwent TKRs.
Overall the study results showed that if 100 patients had a UKR rather than a TKR there would be one fewer death and three more re-operations in the first 4 years after surgery.
Disclosures: Pandit is a paid speaker for Biomet. Murray receives royalties related to the Oxford UKR and is a paid consultant for Biomet. Judge received honoraria from Roche, held advisory board positions for Anthera and received consortium research greats from Servier.
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