Unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplasty

Abstract Background While multiple studies have demonstrated a lower venous thromboembolism disease (VTED) risk for unicompartmental knee arthroplasty (UKA) compared to primary total knee arthroplasty (TKA), recent reports have shown that revision TKA also had a lower VTED risk compared to primary T...

Full description

Bibliographic Details
Main Authors: Andrew M. Schneider, Daniel R. Schmitt, Nicholas M. Brown
Format: Article
Language:English
Published: BMC 2020-11-01
Series:Knee Surgery & Related Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s43019-020-00078-9
id doaj-564f5e73c661430598171a9947aeaaf6
record_format Article
spelling doaj-564f5e73c661430598171a9947aeaaf62020-11-25T04:07:34ZengBMCKnee Surgery & Related Research2234-24512020-11-013211610.1186/s43019-020-00078-9Unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplastyAndrew M. Schneider0Daniel R. Schmitt1Nicholas M. Brown2Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical CenterDepartment of Orthopaedic Surgery and Rehabilitation, Loyola University Medical CenterDepartment of Orthopaedic Surgery and Rehabilitation, Loyola University Medical CenterAbstract Background While multiple studies have demonstrated a lower venous thromboembolism disease (VTED) risk for unicompartmental knee arthroplasty (UKA) compared to primary total knee arthroplasty (TKA), recent reports have shown that revision TKA also had a lower VTED risk compared to primary TKA, an unexpected finding because of its theoretical increased risk. Given the paucity of up-to-date comparative studies, our goal was to perform a high-powered VTED risk comparison study of UKA and revision TKA to primary TKA using recent data. Methods The National Surgical Quality Improvement Program (NSQIP) database was queried between 2011 and 2018, and we identified 213,234 patients for inclusion: 191,810 primary TKA, 9294 UKA, and 12,130 revision TKA. Demographics, medical comorbidities, and possible VTE risk factors were collected. Thirty-day outcomes, including deep vein thrombosis (DVT), pulmonary embolism (PE), and all-cause VTED were compared between knee arthroplasty types. Results On multivariate analysis, UKA was significantly associated with lower rates of DVT [OR 0.44 (0.31–0.61); P < 0.001], PE [OR 0.42 (0.28–0.65); P < 0.001], and all-cause VTED [OR 0.42 (0.32–0.55); P < 0.001] when compared to primary TKA. Revision TKA was significantly associated with lower rates of PE [OR 0.62 (0.47–0.83); P = 0.002], and all-cause VTED [OR 0.82 (0.70–0.98); P = 0.029] when compared to primary TKA. Conclusions Utilizing recent data from a nationwide patient cohort and controlling for confounding variables, our results showed that both revision TKA and UKA had a lower risk of VTED compared to primary TKA, corroborating the results of recent investigations. Additional prospective investigations are needed to explain this unexpected result.http://link.springer.com/article/10.1186/s43019-020-00078-9Total knee arthroplastyUnicompartmental knee arthroplastyVenous thromboembolic diseaseRevision knee arthroplasty
collection DOAJ
language English
format Article
sources DOAJ
author Andrew M. Schneider
Daniel R. Schmitt
Nicholas M. Brown
spellingShingle Andrew M. Schneider
Daniel R. Schmitt
Nicholas M. Brown
Unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplasty
Knee Surgery & Related Research
Total knee arthroplasty
Unicompartmental knee arthroplasty
Venous thromboembolic disease
Revision knee arthroplasty
author_facet Andrew M. Schneider
Daniel R. Schmitt
Nicholas M. Brown
author_sort Andrew M. Schneider
title Unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplasty
title_short Unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplasty
title_full Unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplasty
title_fullStr Unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplasty
title_full_unstemmed Unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplasty
title_sort unicompartmental knee arthroplasty and revision total knee arthroplasty have a lower risk of venous thromboembolism disease at 30 days than primary total knee arthroplasty
publisher BMC
series Knee Surgery & Related Research
issn 2234-2451
publishDate 2020-11-01
description Abstract Background While multiple studies have demonstrated a lower venous thromboembolism disease (VTED) risk for unicompartmental knee arthroplasty (UKA) compared to primary total knee arthroplasty (TKA), recent reports have shown that revision TKA also had a lower VTED risk compared to primary TKA, an unexpected finding because of its theoretical increased risk. Given the paucity of up-to-date comparative studies, our goal was to perform a high-powered VTED risk comparison study of UKA and revision TKA to primary TKA using recent data. Methods The National Surgical Quality Improvement Program (NSQIP) database was queried between 2011 and 2018, and we identified 213,234 patients for inclusion: 191,810 primary TKA, 9294 UKA, and 12,130 revision TKA. Demographics, medical comorbidities, and possible VTE risk factors were collected. Thirty-day outcomes, including deep vein thrombosis (DVT), pulmonary embolism (PE), and all-cause VTED were compared between knee arthroplasty types. Results On multivariate analysis, UKA was significantly associated with lower rates of DVT [OR 0.44 (0.31–0.61); P < 0.001], PE [OR 0.42 (0.28–0.65); P < 0.001], and all-cause VTED [OR 0.42 (0.32–0.55); P < 0.001] when compared to primary TKA. Revision TKA was significantly associated with lower rates of PE [OR 0.62 (0.47–0.83); P = 0.002], and all-cause VTED [OR 0.82 (0.70–0.98); P = 0.029] when compared to primary TKA. Conclusions Utilizing recent data from a nationwide patient cohort and controlling for confounding variables, our results showed that both revision TKA and UKA had a lower risk of VTED compared to primary TKA, corroborating the results of recent investigations. Additional prospective investigations are needed to explain this unexpected result.
topic Total knee arthroplasty
Unicompartmental knee arthroplasty
Venous thromboembolic disease
Revision knee arthroplasty
url http://link.springer.com/article/10.1186/s43019-020-00078-9
work_keys_str_mv AT andrewmschneider unicompartmentalkneearthroplastyandrevisiontotalkneearthroplastyhavealowerriskofvenousthromboembolismdiseaseat30daysthanprimarytotalkneearthroplasty
AT danielrschmitt unicompartmentalkneearthroplastyandrevisiontotalkneearthroplastyhavealowerriskofvenousthromboembolismdiseaseat30daysthanprimarytotalkneearthroplasty
AT nicholasmbrown unicompartmentalkneearthroplastyandrevisiontotalkneearthroplastyhavealowerriskofvenousthromboembolismdiseaseat30daysthanprimarytotalkneearthroplasty
_version_ 1724428362349281280