Conversion total knee arthroplasty: A case complexity between primary and revision total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Arthroplasty Research
• Patient Safety

Background:

• Conversion total knee arthroplasty (TKA) is a complex procedure.
• Comparing 30-day complications of conversion TKA versus primary and revision TKA is crucial.

Purpose of the Study:

• To compare 30-day complications between conversion TKA and primary TKA.
• To compare 30-day complications between conversion TKA and revision TKA.

Main Methods:

• Utilized the National Surgical Quality Improvement Program database (2006-2018).
• Included adult patients undergoing conversion TKA, primary TKA, and aseptic revision TKA.
• Assessed 30-day complications using bivariate analyses and multivariate logistic regressions.

Main Results:

• Conversion TKA patients faced higher risks of overall complications, mortality, wound complications, cardiac issues, bleeding, and reoperation versus primary TKA.
• Conversion TKA patients had a lower risk of septic complications compared to revision TKA patients.

Conclusions:

• Conversion TKA is linked to significantly higher complication rates than primary TKA.
• Conversion TKA presents a lower sepsis risk than revision TKA.
• Current reimbursement models need revision to reflect conversion TKA's complexity, aligning with revision TKA reimbursements.