Adverse outcomes after total and unicompartmental knee replacement in 101 330 matched patients: a study of data from the National Joint Registry for England and Wales

Publication date: 18–24 October 2014 Source:The Lancet, Volume 384, Issue 9952 Author(s): Alexander D Liddle , Andrew Judge , Hemant Pandit , David W Murray Background Total knee replacement (TKR) or unicompartmental knee replacement (UKR) are options for end-stage osteoarthritis. However, comparisons between the two procedures are confounded by differences in baseline characteristics of patients undergoing either procedure and by insufficient reporting of endpoints other than revision. We aimed to compare adverse outcomes for each procedure in matched patients. Methods With propensity score techniques, we compared matched patients undergoing TKR and UKR in the National Joint Registry for England and Wales. The National Joint Registry started collecting data in April 1, 2003, and is continuing. The last operation date in the extract of data used in our study was Aug 28, 2012. We linked data for multiple potential confounders from the National Health Service Hospital Episode Statistics database. We used regression models to compare outcomes including rates of revision, revision/reoperation, complications, readmission, mortality, and length of stay. Findings 25 334 UKRs were matched to 75 996 TKRs on the basis of propensity score. UKRs had worse implant survival both for revision (subhazard ratio [SHR] 2·12, 95% CI 1·99–2·26) and for revision/reoperation (1·38, 1·31–1·44) than TKRs at 8 years. Mortality was significantly higher for TKR at all timepoi...
Source: The Lancet - Category: Journals (General) Source Type: research