In the Journals

Decreased opioid use, increased revision risk seen after unicompartmental vs total knee replacement

Unicompartmental knee replacement compared with total knee replacement correlated with a decreased risk of postoperative opioid use and a lower risk of venous thromboembolism, according to study results. However, unicompartmental replacement had an increased risk of revision.

Using one U.S. and four U.K. databases, researchers identified patients who were at least 40 years old and had osteoarthritis. Of these patients, 33,867 underwent unicompartmental knee replacement (UKR) and 557,831 patients underwent total knee replacement (TKR). In all databases, opioid use between 91 and 365 days postoperatively was assessed for all patients. Investigators assessed postoperative complications at 60 days postoperatively and implant survival at 5 years. All databases evaluated outcomes apart from readmission, which was evaluated in three databases. Mortality was evaluated in two databases. Propensity score-matched Cox proportional hazards models were created for each outcome measure. To account for observed differences in control outcomes, investigators generated calibrated hazard ratios and then combined these with their meta-analysis. Overall, 32,379 patients who underwent UKR and 250,377 patients who underwent TKR were propensity score matched.

Results showed UKR correlated with a decreased risk of postoperative opioid use and decreased risk of venous thromboembolism. There was also a correlation between UKR and an increased risk of revision. However, no differences were seen between UKR and TKR for infection and readmission. Investigators noted there was not enough evidence to demonstrate whether the mortality risk decreased with the type of replacement. – by Monica Jaramillo

 

Disclosures: The researchers report no relevant financial disclosures.

Unicompartmental knee replacement compared with total knee replacement correlated with a decreased risk of postoperative opioid use and a lower risk of venous thromboembolism, according to study results. However, unicompartmental replacement had an increased risk of revision.

Using one U.S. and four U.K. databases, researchers identified patients who were at least 40 years old and had osteoarthritis. Of these patients, 33,867 underwent unicompartmental knee replacement (UKR) and 557,831 patients underwent total knee replacement (TKR). In all databases, opioid use between 91 and 365 days postoperatively was assessed for all patients. Investigators assessed postoperative complications at 60 days postoperatively and implant survival at 5 years. All databases evaluated outcomes apart from readmission, which was evaluated in three databases. Mortality was evaluated in two databases. Propensity score-matched Cox proportional hazards models were created for each outcome measure. To account for observed differences in control outcomes, investigators generated calibrated hazard ratios and then combined these with their meta-analysis. Overall, 32,379 patients who underwent UKR and 250,377 patients who underwent TKR were propensity score matched.

Results showed UKR correlated with a decreased risk of postoperative opioid use and decreased risk of venous thromboembolism. There was also a correlation between UKR and an increased risk of revision. However, no differences were seen between UKR and TKR for infection and readmission. Investigators noted there was not enough evidence to demonstrate whether the mortality risk decreased with the type of replacement. – by Monica Jaramillo

 

Disclosures: The researchers report no relevant financial disclosures.

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