Total Knee Arthroplasty Has Higher Postoperative Morbidity Than Unicompartmental Knee Arthroplasty: A Multicenter Analysis
Section snippets
Methods
A total of 2235 consecutive primary TKA and 605 consecutive primary UKA procedures were performed at 3 institutions between 2004 and 2009 by 6 surgeons (AVL, CDV, KRB, MEB, PMF, RAM). These cases were retrospectively reviewed for postoperative complications that occurred within 90 days after surgery. All patients included in the study had a minimum 90 days of follow-up; 82 knees in 82 patients were excluded for inadequate follow-up. This study was approved by the institutional review board of
Results
The overall risk of complications for patients undergoing TKA was 11.0%, compared with 4.3% for patients undergoing UKA (P < .0001; Table 3). Because the patients undergoing TKA were somewhat older (mean difference 1.2 years), more likely to be female (67.0% vs 55.3%), and had a higher mean Charlson comorbidity index (0.58 vs 0.43) and a higher mean BMI (34.5 vs 31.1 kg/m2), the association between procedure and complications was assessed in our regression analysis, and TKA was still found to
Discussion
The choice between UKA and TKA for appropriately selected patients remains controversial. Both physicians and patients tend to be complication averse, and if a patient were deemed to be appropriate for either procedure, the risk of perioperative complications would be an important factor to consider when counseling patients on this decision. In this retrospective, multicenter study of more than 2800 patients, we found that TKA was associated with greater perioperative morbidity than UKA.
Acknowledgments
The authors thank Philip M Faris, MD, and Robert A Malinzak, MD, for contributing cases to this series.
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The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2012.03.022.