Registry outcomes of unicompartmental knee arthroplasty revisions

Abstract

Perceptions of the difficulty and outcome of unicompartmental knee arthroplasty revision (rev-UKA) vary. We analyzed differences in the complexity, cost, and survival of rev-UKAs compared with revision TKAs (rev-TKA). One hundred eighty knee arthroplasty revisions (68 rev-UKAs/112 rev-TKAs), defined as a minimum of tibial or femoral component revision, were identified from a community joint registry of 7587 knee implants performed between 1991 and 2005. Four of 68 rev-UKAs (5.9%) were revised a second time, whereas seven of 112 rev-TKAs (6.3%) were rerevised. Rev-TKA was predictably more complex than rev-UKA based on the proxies of operative time, use of modular augmentation and stems, and polyethylene liner thickness. Thirty-nine of 68 rev-UKAs (57%) had no form of augmentation and were revised as primary TKAs. There were more rev-TKAs than rev-UKAs with an implant cost greater than $5200 (42% versus 12%) and hospital charges greater than $33,000 (48% versus 25%). We found no difference in survival between the groups. Although rev-UKAs had less surgical complexity and bone loss at the time of revision compared with rev-TKAs, we were unable to show improved survival of rev-UKAs compared with rev-TKAs. Rev-UKAs were associated with lower implant costs and hospital charges compared with rev-TKAs.

Level of evidence: Level II, prognostic study.

Fig. 1

The graph shows the secondary cumulative revision rate (CRR) by primary revision type. CI = confidence interval.