Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population

Journal of Experimental Orthopaedics

Jack M. Ayres¹  J. Paul Schroeppel¹  Armin Tarakemeh¹  Brandon L. Morris¹  Daniel Reinhardt¹  Scott Mullen¹  Bryan G. Vopat¹ 

[1] Department of Orthopedic Surgery, University of Kansas Medical Center, 3901 Rainbow Bvld, 66160, Kansas City, KS, USA;

关键词: Unicompartmental knee arthroplasty;    Total knee arthroplasty;    Opioid;    Postoperative complication;    Medicare;    Database;   

DOI  :  10.1186/s40634-021-00390-7

来源: Springer

【 摘 要 】

PurposeDespite increased utilization of unicompartmental knee arthroplasty (UKA) for unicompartmental knee osteoarthritis, outcomes in Medicare patients are not well-reported. The purpose of this study is to analyze practice patterns and outcome differences between UKA and TKA in the Medicare population. It is hypothesized that UKA utilization will have increased over the course of the study period and that UKA will be associated with reduced opioid use and lower complication rates compared to TKA.MethodsUsing PearlDiver, the Humana Claims dataset and the Medicare Standard Analytic File (SAF) were analyzed. Patients who underwent UKA and TKA were identified by CPT codes. Postoperative complications were identified by ICD-9/ICD-10 codes. Opioid use was analyzed by the number of days patients were prescribed opioids postoperatively. Survivorship was defined as conversion to TKA.ResultsIn the Humana dataset, 7,808 UKA and 150,680 TKA patients were identified. 8-year survivorship was 87.7% (95% CI [0.861,0.894]). Postoperative opioid use was significantly higher after TKA (186.1 days) compared to UKA (144.7 days) (p < 0.01, Δ = 41.1, 95% CI = [30.41, 52.39]). In the SAF dataset, 20,592 UKA patients and 110,562 TKA patients were identified. Survivorship was highest in patients > 80 years old and lowest in patients < 70 years old. In both datasets, postoperative complication rates were higher in TKA patients compared to UKA patients in nearly all categories.ConclusionsUKA represents an increasingly utilized treatment for osteoarthritis in the Medicare population and may be comparatively advantageous to TKA due to reduced opioid use and complication rates after surgery.Level of evidenceLevel III

【 授权许可】

CC BY