Abstract
Background
There is no consensus on whether unicompartmental arthroplasty (UKA) or high tibial
osteotomy (HTO) is superior for unicompartmental arthritis. While there are studies
comparing revision and complication rates, none matched a large number of patients
undergoing HTO and UKA in the United States and compared these outcomes. We investigated
TKA conversion rate and the complications following HTO or UKA.
Methods
This retrospective study queried the PearlDiver database of all patients undergoing
UKA and HTO using CPT codes between January 2011 and January 2020. We compared propensity-matched
populations based on age, gender, Charlson comorbidity index, and Elixhauser comorbidity
index to compare odds of complications, TKA conversion, and drug use between UKA and
HTO groups. Two-independent sample t-test for unequal variances and test of significance
were performed.
Results
We found 32,583 UKA patients and 816 HTO patients. Each matched group had 535 patients.
One-year complication showed higher risk of pneumonia, hematoma, infection, and mechanical
complications among HTO patients. UKA patients used narcotics on average of 10.3 days
compared to 9.1 days among HTO patients (P < .01). UKA conversion rates were 4.1%, 5.4%, 7.7%, and 9.2% at 1-, 2-, 5-, and 10-year
intervals, respectively. HTO conversion rates were less than 2% at 1- and 2-year intervals,
3.4% at 5-year, and 4.5% at 10-year intervals. This difference was statistically significant
at 5- and 10-year intervals (P < .01).
Conclusions
Using large matched cohorts, HTO may be converted to TKA later than UKA in short-
to mid-term follow-up, and HTO patients used opioids for shorter duration.
Keywords
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Article info
Publication history
Published online: February 28, 2023
Accepted:
January 14,
2023
Received in revised form:
November 22,
2022
Received:
September 18,
2022
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons.
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