Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures
Background: There is no consensus on whether unicompartmental arthroplasty (UKA) or high tibial osteotomy (HTO) is superior for unicompartmental arthritis. While there are studies comparing revision and complication rates, none matched a large number of patients undergoing HTO and UKA in the United...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344123000122 |
| _version_ | 1797860237643874304 |
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| author | Philip A. Serbin, MD Dang-Huy Do, MD Andrew Hinkle, MD Dane Wukich, MD Michael Huo, MD Senthil Sambandam, MD |
| author_facet | Philip A. Serbin, MD Dang-Huy Do, MD Andrew Hinkle, MD Dane Wukich, MD Michael Huo, MD Senthil Sambandam, MD |
| author_sort | Philip A. Serbin, MD |
| collection | DOAJ |
| description | Background: There is no consensus on whether unicompartmental arthroplasty (UKA) or high tibial osteotomy (HTO) is superior for unicompartmental arthritis. While there are studies comparing revision and complication rates, none matched a large number of patients undergoing HTO and UKA in the United States and compared these outcomes. We investigated TKA conversion rate and the complications following HTO or UKA. Methods: This retrospective study queried the PearlDiver database of all patients undergoing UKA and HTO using CPT codes between January 2011 and January 2020. We compared propensity-matched populations based on age, gender, Charlson comorbidity index, and Elixhauser comorbidity index to compare odds of complications, TKA conversion, and drug use between UKA and HTO groups. Two-independent sample t-test for unequal variances and test of significance were performed. Results: We found 32,583 UKA patients and 816 HTO patients. Each matched group had 535 patients. One-year complication showed higher risk of pneumonia, hematoma, infection, and mechanical complications among HTO patients. UKA patients used narcotics on average of 10.3 days compared to 9.1 days among HTO patients (P < .01). UKA conversion rates were 4.1%, 5.4%, 7.7%, and 9.2% at 1-, 2-, 5-, and 10-year intervals, respectively. HTO conversion rates were less than 2% at 1- and 2-year intervals, 3.4% at 5-year, and 4.5% at 10-year intervals. This difference was statistically significant at 5- and 10-year intervals (P < .01). Conclusions: Using large matched cohorts, HTO may be converted to TKA later than UKA in short- to mid-term follow-up, and HTO patients used opioids for shorter duration. |
| first_indexed | 2024-04-09T21:42:15Z |
| format | Article |
| id | doaj.art-b402ddcabce443d288a60b4e773882ee |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-04-09T21:42:15Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-b402ddcabce443d288a60b4e773882ee2023-03-26T05:16:56ZengElsevierArthroplasty Today2352-34412023-04-0120101107Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome MeasuresPhilip A. Serbin, MD0Dang-Huy Do, MD1Andrew Hinkle, MD2Dane Wukich, MD3Michael Huo, MD4Senthil Sambandam, MD5Corresponding author. Department of Orthopaedic Surgery, UT Southwestern, 1801 Inwood Drive, Dallas, TX 75390, USA. Tel.: +1 423 839 6961.; Department of Orthopaedic Surgery, UT Southwestern, Dallas, TX, USADepartment of Orthopaedic Surgery, UT Southwestern, Dallas, TX, USADepartment of Orthopaedic Surgery, UT Southwestern, Dallas, TX, USADepartment of Orthopaedic Surgery, UT Southwestern, Dallas, TX, USADepartment of Orthopaedic Surgery, UT Southwestern, Dallas, TX, USADepartment of Orthopaedic Surgery, UT Southwestern, Dallas, TX, USABackground: There is no consensus on whether unicompartmental arthroplasty (UKA) or high tibial osteotomy (HTO) is superior for unicompartmental arthritis. While there are studies comparing revision and complication rates, none matched a large number of patients undergoing HTO and UKA in the United States and compared these outcomes. We investigated TKA conversion rate and the complications following HTO or UKA. Methods: This retrospective study queried the PearlDiver database of all patients undergoing UKA and HTO using CPT codes between January 2011 and January 2020. We compared propensity-matched populations based on age, gender, Charlson comorbidity index, and Elixhauser comorbidity index to compare odds of complications, TKA conversion, and drug use between UKA and HTO groups. Two-independent sample t-test for unequal variances and test of significance were performed. Results: We found 32,583 UKA patients and 816 HTO patients. Each matched group had 535 patients. One-year complication showed higher risk of pneumonia, hematoma, infection, and mechanical complications among HTO patients. UKA patients used narcotics on average of 10.3 days compared to 9.1 days among HTO patients (P < .01). UKA conversion rates were 4.1%, 5.4%, 7.7%, and 9.2% at 1-, 2-, 5-, and 10-year intervals, respectively. HTO conversion rates were less than 2% at 1- and 2-year intervals, 3.4% at 5-year, and 4.5% at 10-year intervals. This difference was statistically significant at 5- and 10-year intervals (P < .01). Conclusions: Using large matched cohorts, HTO may be converted to TKA later than UKA in short- to mid-term follow-up, and HTO patients used opioids for shorter duration.http://www.sciencedirect.com/science/article/pii/S2352344123000122Unicompartmental arthroplastyHigh tibial osteotomyTotal knee arthroplastyOpioidsConversionOutcomes |
| spellingShingle | Philip A. Serbin, MD Dang-Huy Do, MD Andrew Hinkle, MD Dane Wukich, MD Michael Huo, MD Senthil Sambandam, MD Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures Arthroplasty Today Unicompartmental arthroplasty High tibial osteotomy Total knee arthroplasty Opioids Conversion Outcomes |
| title | Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures |
| title_full | Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures |
| title_fullStr | Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures |
| title_full_unstemmed | Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures |
| title_short | Comparative Analysis of Unicompartmental Total Knee Arthroplasty and High Tibial Osteotomy: Time to Total Knee Arthroplasty and Other Outcome Measures |
| title_sort | comparative analysis of unicompartmental total knee arthroplasty and high tibial osteotomy time to total knee arthroplasty and other outcome measures |
| topic | Unicompartmental arthroplasty High tibial osteotomy Total knee arthroplasty Opioids Conversion Outcomes |
| url | http://www.sciencedirect.com/science/article/pii/S2352344123000122 |
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