Travel Distance Does Not Impact Outcomes Following Unicompartmental Knee Arthroplasty

Unicompartmental knee arthroplasty (UKA) is less frequently performed than total knee arthroplasty, and hence some patients may need to travel to a distant location to have this procedure performed. The purpose of this study was to determine the impact of travel distance on the 90-day outcomes of UKA.

Patients undergoing primary, elective UKA at a single center by one of three fellowship-trained adult reconstruction surgeons between 2017 and 2020 were retrospectively reviewed. Patients were categorized either as "travelers" or "locals" based on whether the distance between their home and the operative location was ≥ 50 miles or < 50 miles, respectively. Primary outcomes included patient-reported outcomes. Secondary outcomes included the rates of 90-day medical and surgical complications, emergency department visits, unplanned readmissions, reoperations, and final range of motion. A total of 83 travelers and 376 locals undergoing UKA were identified. The mean follow-up was 723.7 days (range, 90 to 1,955) and 680.8 days (range, 90 to 2,291) for travelers and locals, respectively (P = 0.54). Travelers were significantly younger (61 versus 64 year old, P = 0.015) and more obese (body mass index 33.6 versus 31.5, P = 0.003). The mean travel distance was 212.1 and 22.0 miles for travelers and locals, respectively (P < 0.001).

There were no differences in any 90-days medical or surgical complications, emergency department visits, unplanned readmissions, reoperations, or final range of motion (all P > 0.05). Travelers demonstrated significantly higher final Knee Society Score and Knee Injury and Osteoarthritis Outcome Score scores; otherwise, there were no significant differences in patient-reported outcomes. There were no differences in the ability to achieve the minimal clinically important difference on any of the studied outcome measures (all P > 0.05).

These data suggest that patients can safely travel distances of ≥ 50 miles to undergo UKA without it impacting medical and surgical complication rates or 90-day outcomes.