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

HSS Journal Online First Article

William W. Schairer, MD
Department of Orthopaedic Surgery, Hospital for Special Surgery

Benedict U. Nwachukwu, MD
Department of Orthopaedic Surgery, Hospital for Special Surgery

Michael D. Hellman, MD
Rush University, Department of Orthopaedic Surgery, Chicgao, Il

Brett R. Levine, MD, MS
Rush University, Department of Orthopaedic Surgery, Chicago, Il

Bryan D. Haughom, MD
Rush University, Department of Orthopaedic Surgery, Chicago, Il

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.

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≥, COPD, recent operation, and blood transfusion to be the risk factors for prolonged length of stay.

Level of Evidence: Prognostic Study Level II

This Online First article was published online in January 2015.
View the full HSS Journal article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.

 

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