No Difference in Postoperative Complications between Simultaneous and Staged, Bilateral Unicompartmental Knee...

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Surgical Outcomes

Background:

• Unicompartmental knee arthroplasty (UKA) is a common procedure for knee osteoarthritis.
• The optimal timing for contralateral UKA surgery is not well-established.
• Understanding complication rates associated with different bilateral UKA timings is crucial for patient management.

Purpose of the Study:

• To compare 90-day postoperative complications between unilateral, simultaneous bilateral, and staged bilateral UKA.
• To determine if the timing of contralateral UKA influences complication risk.

Main Methods:

• Retrospective analysis of the PearlDiver administrative claims database (2015-2020).
• Matched cohort study comparing unilateral UKA with simultaneous bilateral UKA, staged bilateral UKA (1-90 days), and staged bilateral UKA (91-365 days).
• Multivariate analysis to assess the impact of bilateral UKA timing on 90-day postoperative complications.

Main Results:

• A total of 9,638 patients were analyzed: 58.9% unilateral, 4.1% simultaneous bilateral, 15.5% staged (1-90 days), and 21.5% staged (91-365 days).
• Univariate analysis showed a higher incidence of wound dehiscence in simultaneous bilateral UKA (2.1% vs. 0.0%, p=0.040).
• Multivariate analysis revealed no significant increase in any 90-day postoperative complication for simultaneous or staged bilateral UKA compared to unilateral UKA.

Conclusions:

• Bilateral unicompartmental knee arthroplasty, whether performed simultaneously or staged, does not elevate the risk of 90-day postoperative complications.
• These findings support the safety of both simultaneous and staged bilateral UKA approaches.