Abstract
Background and purpose - Both medial unicompartmental knee arthroplasties (UKA) and high tibial osteotomies (HTO) are reliable treatments for isolated medial knee osteoarthritis. However, both may with time need conversion to a total knee arthroplasty (TKA). We conducted the largest nationwide registry comparison of the survival of TKA following UKA with TKA following HTO.Patients and methods - From the Danish Knee Arthroplasty Registry, aseptic conversions to TKA from UKA and TKA converted from HTO within the period of 1997-2018 were retrieved. The Kaplan-Meier method and the Cox proportional hazards regression were used to estimate the survival and hazard ratio (HR) for revision, considering confounding by indication utilizing propensity-score based inverse probability of treatment weighting (PS-IPTW).Results - PS-IPTW yielded a well-balanced pseudo-cohort (standard mean difference (SMD) < 0.1 for all covariates, except implant supplementation) of 963.8 TKAs following UKA and 1139.1 TKAs following HTO. The survival of TKA following UKA was significantly less than that of TKA following HTO with a 5-year estimated survival of 0.88 (95% confidence interval (CI) 0.85-0.90) and 0.94 (CI 0.93-0.96), respectively. The differences in survival corresponded to an implant-supplementation adjusted HR of 2.7 (CI 2.4-3.1) for TKA following UKA compared with TKA following HTO.Interpretation - Previous UKA more than doubled the revision risk of a subsequent TKA compared with previous HTO. This potential risk should be considered in the shared treatment decision of patients who are candidates for both UKA and HTO.
Original language | English |
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Journal | Acta Orthopaedica |
Volume | 91 |
Issue number | 2 |
Pages (from-to) | 177-183 |
Number of pages | 7 |
ISSN | 1745-3674 |
DOIs | |
Publication status | Published - Apr 2020 |
Keywords
- Adult
- Aged
- Aged, 80 and over
- Arthroplasty, Replacement, Knee/adverse effects
- Cohort Studies
- Denmark
- Female
- Humans
- Kaplan-Meier Estimate
- Knee Prosthesis
- Male
- Middle Aged
- Osteoarthritis, Knee/surgery
- Osteotomy/adverse effects
- Propensity Score
- Prosthesis Failure/etiology
- Registries
- Reoperation/statistics & numerical data
- Risk Assessment/methods
- Tibia/surgery
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Dive into the research topics of 'Reduced survival of total knee arthroplasty after previous unicompartmental knee arthroplasty compared with previous high tibial osteotomy: a propensity-score weighted mid-term cohort study based on 2,133 observations from the Danish Knee Arthroplasty Registry'. Together they form a unique fingerprint.Datasets
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Reduced survival of total knee arthroplasty after previous unicompartmental knee arthroplasty compared with previous high tibial osteotomy: a propensity-score weighted mid-term cohort study based on 2,133 observations from the Danish Knee Arthroplasty Registry
Jensen, S. L. (Creator), Kappel, A. (Creator), El-Galaly, A. (Creator) & Nielsen, P. T. (Creator), Taylor & Francis, 2020
DOI: 10.6084/m9.figshare.11590467.v1, https://doi.org/10.6084%2Fm9.figshare.11590467.v1
Dataset