A Matched Comparison of Long-Term Outcomes of Total and Unicompartmental Knee Replacements in Different Ages Based on National Databases: Analysis of Data From the National Joint Registry for England, Wales, Northern Ireland, and the Isle of Man

摘要

Background: The 2 main treatment options for end-stage single compartment knee arthritis are unicompartmental (UKR) or total knee replacement (TKR). We compared the long-term outcomes in different age groups. Methods: In total, 54,215 UKRs and 54,215 TKRs from the National Joint Registry and Hospital Episode Statistics database were propensity score matched and Kaplan-Meier and regression analysis used to compare revision, reoperation, mortality, and 3-month complications. Results: UKR had higher 10-year revision rates (12 vs 5, hazard ratio HR 2.31, P= 75 years old there would be 3 more reoperations and 4 less deaths. Conclusion: UKR has higher revision and slightly higher reoperation rates but lower mortality rates than matched TKR. The decision to do a UKR should, in part, be based on the balance of these risks, which are influenced by patient age. In the elderly group (>75 years) the data suggests that UKR compared to TKR has a greater absolute reduction in mortality than the increase in reoperation rate. Levels of evidence: III. (C) 2021 Elsevier Inc. All rights reserved.