Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea
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 su...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2021-03, Vol.141 (3), p.477-488 |
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| description | 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. |
| doi_str_mv | 10.1007/s00402-020-03675-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2460767829</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2492125733</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-372f7c746f1052a53593b5bad2ec204e5c4992c0312a9afdf73e5f18060646c23</originalsourceid><addsrcrecordid>eNp9kU1rFTEUhoMo9lr9Ay4k4MbN2JNkMpm4k2JVLAh-rENu5sQ77UwyJhn0_iD_Z9PeakHEVUjyvOc98BDylMFLBqBOMkALvAEODYhOyYbdIxvWirYRmnX3yQa06JoeJDsij3K-AGC81_CQHAnB-lYBbMivT2O-pNFTS12clwkLUvzpdjZ8QxoT9Xac1oR0DLTEYid6GRCpTWWX4jLZXPbUhoGuYbyO1_cZwz-xV7Uh2DLG8GMckC5xWaeba7O1GYfavoup0FzWYU99ijP9HNeyox9iQvuYPPB2yvjk9jwmX8_efDl915x_fPv-9PV544SSpRGKe-VU23kGklsppBZbubUDR8ehRelarbkDwbjV1g9eCZSe9dBB13aOi2Py4jB3SfH7irmYecwOp8kGjGs2vO1AdarnuqLP_0Iv4ppC3a5SmjMulRCV4gfKpZhzQm-WNM427Q0Dcy3RHCSaKtHcSDSshp7djl63Mw5_Ir-tVUAcgFy_qqh01_2fsVfL_6n_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2492125733</pqid></control><display><type>article</type><title>Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea</title><source>SpringerLink Journals</source><creator>Han, Seung-Beom ; Song, Si-Young ; Shim, Jae-Hoon ; Shin, Young-Soo</creator><creatorcontrib>Han, Seung-Beom ; Song, Si-Young ; Shim, Jae-Hoon ; Shin, Young-Soo</creatorcontrib><description>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.</description><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-020-03675-1</identifier><identifier>PMID: 33184700</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Chronic obstructive pulmonary disease ; Cohort analysis ; Joint replacement surgery ; Joint surgery ; Knee Arthroplasty ; Medicine ; Medicine & Public Health ; Orthopedics ; Population-based studies ; Risk factors</subject><ispartof>Archives of orthopaedic and trauma surgery, 2021-03, Vol.141 (3), p.477-488</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-372f7c746f1052a53593b5bad2ec204e5c4992c0312a9afdf73e5f18060646c23</citedby><cites>FETCH-LOGICAL-c375t-372f7c746f1052a53593b5bad2ec204e5c4992c0312a9afdf73e5f18060646c23</cites><orcidid>0000-0003-1030-9979</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-020-03675-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-020-03675-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33184700$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Han, Seung-Beom</creatorcontrib><creatorcontrib>Song, Si-Young</creatorcontrib><creatorcontrib>Shim, Jae-Hoon</creatorcontrib><creatorcontrib>Shin, Young-Soo</creatorcontrib><title>Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>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.</description><subject>Chronic obstructive pulmonary disease</subject><subject>Cohort analysis</subject><subject>Joint replacement surgery</subject><subject>Joint surgery</subject><subject>Knee Arthroplasty</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Population-based studies</subject><subject>Risk factors</subject><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU1rFTEUhoMo9lr9Ay4k4MbN2JNkMpm4k2JVLAh-rENu5sQ77UwyJhn0_iD_Z9PeakHEVUjyvOc98BDylMFLBqBOMkALvAEODYhOyYbdIxvWirYRmnX3yQa06JoeJDsij3K-AGC81_CQHAnB-lYBbMivT2O-pNFTS12clwkLUvzpdjZ8QxoT9Xac1oR0DLTEYid6GRCpTWWX4jLZXPbUhoGuYbyO1_cZwz-xV7Uh2DLG8GMckC5xWaeba7O1GYfavoup0FzWYU99ijP9HNeyox9iQvuYPPB2yvjk9jwmX8_efDl915x_fPv-9PV544SSpRGKe-VU23kGklsppBZbubUDR8ehRelarbkDwbjV1g9eCZSe9dBB13aOi2Py4jB3SfH7irmYecwOp8kGjGs2vO1AdarnuqLP_0Iv4ppC3a5SmjMulRCV4gfKpZhzQm-WNM427Q0Dcy3RHCSaKtHcSDSshp7djl63Mw5_Ir-tVUAcgFy_qqh01_2fsVfL_6n_</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Han, Seung-Beom</creator><creator>Song, Si-Young</creator><creator>Shim, Jae-Hoon</creator><creator>Shin, Young-Soo</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1030-9979</orcidid></search><sort><creationdate>20210301</creationdate><title>Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea</title><author>Han, Seung-Beom ; Song, Si-Young ; Shim, Jae-Hoon ; Shin, Young-Soo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-372f7c746f1052a53593b5bad2ec204e5c4992c0312a9afdf73e5f18060646c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Chronic obstructive pulmonary disease</topic><topic>Cohort analysis</topic><topic>Joint replacement surgery</topic><topic>Joint surgery</topic><topic>Knee Arthroplasty</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Population-based studies</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Han, Seung-Beom</creatorcontrib><creatorcontrib>Song, Si-Young</creatorcontrib><creatorcontrib>Shim, Jae-Hoon</creatorcontrib><creatorcontrib>Shin, Young-Soo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Han, Seung-Beom</au><au>Song, Si-Young</au><au>Shim, Jae-Hoon</au><au>Shin, Young-Soo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>141</volume><issue>3</issue><spage>477</spage><epage>488</epage><pages>477-488</pages><issn>0936-8051</issn><eissn>1434-3916</eissn><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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33184700</pmid><doi>10.1007/s00402-020-03675-1</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-1030-9979</orcidid></addata></record> |
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| source | SpringerLink Journals |
| subjects | Chronic obstructive pulmonary disease Cohort analysis Joint replacement surgery Joint surgery Knee Arthroplasty Medicine Medicine & Public Health Orthopedics Population-based studies Risk factors |
| title | Risk of a complete exchange or failure in total knee arthroplasty and unicompartmental knee arthroplasty: a nationwide population-based cohort study from South Korea |
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