An Analysis of Risk Factors for Short-Term Complication Rates and Increased Length of Stay following Unicompartmental Knee Arthroplasty

Abstract

Background: Unicompartmental knee arthroplasty (UKA) is an increasingly popular procedure, with excellent long-term outcomes. However, there are only a limited number of reports reporting its short-term morbidity and mortality. Questions/Purposes: We sought to analyze the reported 30-day morbidity, mortality, and risk factors for complications and prolonged length of stay (>4 days) following UKA. Patients and Methods: Utilizing the National Surgical Quality Improvement Program (NSQIP) database, including patients (n=2316) from 2005-2012, we correlated the reported 30-day complications and prolonged length of stay with patient demographics and risk factors. Results: The overall rate of complications was low (3.2%). The distribution of complications demonstrated 0.5% major systemic, 1.4% minor systemic, 0.7% major local, and 0.9% minor local complications, with a 2.1% readmission rate. Multivariate regression demonstrated increased BMI and a history of chronic obstructive pulmonary disease (COPD) as independent risk factors for complications. Furthermore, multivariate regression demonstrated increased BMI, ASA ≥ 3, history of COPD, recent operation, and postoperative transfusion as independent risk factors for prolonged length of hospitalization. Conclusions: Utilizing the NSQIP, we present one of the largest studies to date evaluating complications following UKA. Our multivariate model demonstrated obesity and COPD to be the risk factors for complications while obesity, ASA≥3, COPD, recent operation, and blood transfusion to be the risk factors for prolonged length of stay.

Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty

“…In addition, a significantly longer hospital stay (p < 0.001) was explored in our RCC patients. This is in line with our results and previous investigators who found longer hospital stay for patients who received more blood transfusions in total knee arthroplasty 16 17 . Of note, PAT patients in our study population had a higher rate of preoperative ASA > 2 (‘severe systemic disease’ or worse) but preoperative ASA > 2 revealed no significant independent risk factor for postoperative RCC demand in our multivariate regression model ( Table 4 ).…”

Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up

“…In our study, patients with normal weight had an annual revision rate of 0.28 while patients with class II-III obesity had an annual revision rate of 1.36; these findings are similar to current literature findings. Haughom and colleagues showed in a database analysis of 2316 UKAs that BMI was a significant risk factor for revision [68], while Kandil and colleagues showed in a national database study of 15770 UKAs that obesity and morbid obesity were risk factors for complications and revisions [69]. Interestingly, Bonutti et al [70] and Berend et al [71] showed that a higher BMI was associated with higher revision rate at two to three year follow-up, while other studies could not find a correlation between BMI and revision rates at long-term follow-up [72–77].…”

Medical Comorbidities and Functional Dependent Living Are Independent Risk Factors for Short-Term Complications Following Osteotomy Procedures about the Knee

“…The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database is a national database that has previously been used to report on short-term outcomes regarding many orthopedic interventions. [20][21][22] The authors hypothesized that medical comorbidities including diabetes, smoking, and older age would be associated with higher rates of short term adverse events following an osteotomy about the knee.…”