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...
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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 |
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