Unicompartmental Knee Arthroplasty in Octogenarians: A National Database Analysis Including Over 700 Octogenarians

Unicompartmental knee arthroplasty (UKA) may be considered for select patients to relieve pain and restore function of the knee joint. Little research to date has explored the complication profile of UKA in an older population. The current study uses a large national surgical database to examine the 30-day postoperative adverse events in octogenarians compared with those in nonoctogenarians.

The 2012-2018 National Surgical Quality Improvement Program database was queried for all patients undergoing UKA for osteoarthritis. Those patients aged 80 years or older composed the octogenarian age group. Demographics and medical comorbidities were cataloged, in addition to 30-day adverse events. Multivariate regression analysis controlled for differences in demographics and comorbidities. Significance was set at P < .05.

A total of 10,103 patients undergoing UKA were identified, of which 728 (7.2%) were octogenarians. The octogenarian cohort had significantly higher comorbidity burden than nonoctogenarians. After controlling for demographics other than age, American Society of Anesthesiologists score, and medical comorbidities, octogenarians had higher 30-day odds of death (odds ratio [OR] = 6.12, P = .024), minor adverse events (OR = 2.97, P = .001), prolonged hospital length of stay (OR = 2.30, <0.001), nonhome discharge (OR = 4.50, P < .001), and readmission (OR = 1.72, P = .015), but did not experience increased odds of serious adverse events (OR = 1.07, P = .172) or return to the operating room (OR = 0.97, P = .881).

The present study found a statistically significant increase in several adverse events within 30 days of surgery for patients aged ≥80 years when compared with patients younger than 80 years. Namely, UKA in octogenarians was associated with significantly increased odds of short-term mortality, urinary tract infection, transfusion, prolonged hospital stay, and readmission.