Document Type
Conference Proceeding
Publication Date
4-11-2024
Abstract
OBJECTIVE: Cemented total knee arthroplasty (TKA) is the gold standard treatment for osteoarthritis, but uncemented TKA offers benefits like improved osseointegration and reduced complications from cement debris. This study aimed to investigate (1) if there has been a rise in uncemented TKA and (2) if there are differences in early complications between cemented and uncemented TKA. METHODS: We retrospectively reviewed data from the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) database of primary TKA patients from 2017 to 2021 at a single health system (six hospitals). Uncemented TKA (uncemented fixation for femur and tibia) patients were analyzed for demographics and 90-day postoperative events. Hybrid or reverse hybrid fixation (cemented and uncemented components mixed) were collected for fixation rate trends, but excluded from analysis. RESULTS: 18,749 primary TKAs were identified. Fixation method: 89.7% cemented, 9.7% uncemented, 0.5% hybrid, 0.2% reverse hybrid. Mean age was 67, 83.7% were Caucasian, and 64.2% were female, with a mean BMI of 33 kg/m2 . Uncemented TKA patients were more likely younger, male, heavier, current smokers, and diabetics than cemented TKA patients (p<0.0001, p=0.03). Uncemented patients had a shorter length of stay (p=<0.0001) and were on fewer preoperative medications: anticoagulants (p=0.0059), antiplatelets (p=< 0.0001), opioids (p=0.0091), steroids (p=0.0039). The rate of uncemented TKA increased yearly, from 3.3% (n=145) in 2017 to 17.1% (n=512) in 2021. Cemented TKA rate fell from 96.2% (n=4,252) in 2017 to 81.9% (n=2,450) in 2021. Readmission rate was higher in cemented TKAs (n=671, 4%) vs. uncemented TKAs (n=48, 2.6%) (p=0.0048) during the 90-day post-op period. Though underpowered to show equivalence, no other statistically significant differences in outcomes existed. CONCLUSION: The rate of uncemented TKA increased steadily from 2017 to 2021. Uncemented TKA was associated with lower readmission rates and did not appear to have a higher rate of 90-day complications compared to cemented TKAs.
Recommended Citation
Farley KX, Dean RS, Auch E, Karadsheh M, Moore D. Risk factors for failure of same-day discharge total knee arthroplasty. Presented at: Mid-America Orthopaedic Association 41st Annual Meeting; 2024 Apr 11; Bonita Springs, FL. Available from:https://maoa.memberclicks.net/assets/Abstracts/MAOA%202024%20abstracts.pdf
Comments
Mid-America Orthopaedic Association 41st Annual Meeting, April 10-14, 2024, Bonita Springs, FL