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. 2024 Dec:51:130-135.
doi: 10.1016/j.knee.2024.08.016. Epub 2024 Sep 10.

Unicompartmental knee arthroplasty in octogenarians: An analysis of 1,466 patients with 2-year follow-up

Alexander J Acuña  1 , Enrico M Forlenza  1 , Joseph Serino 3rd  1 , Vince K Morgan  1 , Tad L Gerlinger  1 , Craig J Della Valle  2
Affiliations

Unicompartmental knee arthroplasty in octogenarians: An analysis of 1,466 patients with 2-year follow-up

Alexander J Acuña et al. Knee. 2024 Dec.

Abstract

Introduction: Unicompartmental knee arthroplasty (UKA) has been shown to improve pain and function in appropriately selected patients. Limited data exists regarding outcomes and complication rates following UKA among octogenarians.

Methods: The PearlDiver Mariner database was queried for patients undergoing primary UKA between 2010-2022. Patients < 80 years old were matched 4:1 to the octogenarian cohort (≥80 years old) by sex, year, Elixhauser Comorbidity Index (ECI), tobacco use, obesity, and diabetes. A total of 1,334 octogenarians and 5,313 controls were included in our analysis. Multivariate logistic regression was utilized to compare medical complications at 90-days post-operatively and surgical complications at 1- and 2-years post-operatively. Our regression analysis controlled for sex, ECI, tobacco use, obesity, and diabetes.

Results: Octogenarians had an increased risk of acute kidney injury (OR: 2.306, 95% CI: 1.393-3.749; p < 0.001), pneumonia (OR: 2.367, 95% CI: 1.301-4.189; p = 0.003), UTI (OR: 1.846, 95% CI: 1.304-2.583; p < 0.001), ED visits (OR: 2.229, 95% CI: 1.586-3.105; p < 0.001), and any complication (OR: 1.575, 95% CI: 1.304-1.895; p < 0.001) at 90-days post-operatively. Octogenarians had lower odds of all-cause revision at 2-years (OR: 0.607, 95% CI: 0.382-0.923; p = 0.026). No differences were demonstrated between cohorts in rates of PJI (OR: 0.832, 95% CI: 0.334-1.796; p = 0.664), periprosthetic fracture (OR: 0.516, 95% CI: 0.120-1.520; p = 0.289), or aseptic loosening (OR: 0.285, 95% CI: 0.045-1.203; p = 0.088) at 2-years.

Discussion: These findings suggest that despite an increased risk of certain medical complications within the acute post-operative period, octogenarians undergoing UKA experienced similar rates of surgical complications to younger matched controls at 2-year follow-up.

Keywords: Complications; Octogenarians; Outcomes; Survivorship; Unicompartmental arthroplasty (UKA).

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [CDV reports the following disclosures: Royalties (BD, Smith & Nephew, Wolters Kluwer), Paid consultant (Depuy, Zimmer), Stock or stock options (Parvizi Surgical Innovations), Researchs support (Smith & Nephew, Zimmer, Stryker), Other financial support (Wolters Kluwer Health, SLACK incorporated), and Board/Committee member (Arthritis Foundation, Knee Society, Orthopedics Today, MidAmerica Orthopaedic Association). TG reports the following disclosures: IP Royalties (Smith & Nephew), Paid consultant (Smith & Nephew), and research support (Smith & Nephew). AJA, EF, JS, and VM. have nothing to disclose.].

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