Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population

Abstract Purpose Despite increased utilization of unicompartmental knee arthroplasty (UKA) for unicompartmental knee osteoarthritis, outcomes in Medicare patients are not well-reported. The purpose of this study is to analyze practice patterns and outcome differences between UKA and TKA in the Medic...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Brandon L. Morris, Jack M. Ayres, Daniel Reinhardt, Armin Tarakemeh, Scott Mullen, J. Paul Schroeppel, Bryan G. Vopat
Formato:	article
Lenguaje:	EN
Publicado:	SpringerOpen 2021
Materias:	Unicompartmental knee arthroplasty Total knee arthroplasty Opioid Postoperative complication Medicare Database Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/a57361fbc00c4052a10fb42f3327d57e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a57361fbc00c4052a10fb42f3327d57e
record_format	dspace
spelling	oai:doaj.org-article:a57361fbc00c4052a10fb42f3327d57e2021-11-14T12:27:28ZUnicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population10.1186/s40634-021-00390-72197-1153https://doaj.org/article/a57361fbc00c4052a10fb42f3327d57e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s40634-021-00390-7https://doaj.org/toc/2197-1153Abstract Purpose Despite increased utilization of unicompartmental knee arthroplasty (UKA) for unicompartmental knee osteoarthritis, outcomes in Medicare patients are not well-reported. The purpose of this study is to analyze practice patterns and outcome differences between UKA and TKA in the Medicare population. It is hypothesized that UKA utilization will have increased over the course of the study period and that UKA will be associated with reduced opioid use and lower complication rates compared to TKA. Methods Using PearlDiver, the Humana Claims dataset and the Medicare Standard Analytic File (SAF) were analyzed. Patients who underwent UKA and TKA were identified by CPT codes. Postoperative complications were identified by ICD-9/ICD-10 codes. Opioid use was analyzed by the number of days patients were prescribed opioids postoperatively. Survivorship was defined as conversion to TKA. Results In the Humana dataset, 7,808 UKA and 150,680 TKA patients were identified. 8-year survivorship was 87.7% (95% CI [0.861,0.894]). Postoperative opioid use was significantly higher after TKA (186.1 days) compared to UKA (144.7 days) (p < 0.01, Δ = 41.1, 95% CI = [30.41, 52.39]). In the SAF dataset, 20,592 UKA patients and 110,562 TKA patients were identified. Survivorship was highest in patients > 80 years old and lowest in patients < 70 years old. In both datasets, postoperative complication rates were higher in TKA patients compared to UKA patients in nearly all categories. Conclusions UKA represents an increasingly utilized treatment for osteoarthritis in the Medicare population and may be comparatively advantageous to TKA due to reduced opioid use and complication rates after surgery. Level of evidence Level IIIBrandon L. MorrisJack M. AyresDaniel ReinhardtArmin TarakemehScott MullenJ. Paul SchroeppelBryan G. VopatSpringerOpenarticleUnicompartmental knee arthroplastyTotal knee arthroplastyOpioidPostoperative complicationMedicareDatabaseOrthopedic surgeryRD701-811ENJournal of Experimental Orthopaedics, Vol 8, Iss 1, Pp 1-18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Unicompartmental knee arthroplasty Total knee arthroplasty Opioid Postoperative complication Medicare Database Orthopedic surgery RD701-811
spellingShingle	Unicompartmental knee arthroplasty Total knee arthroplasty Opioid Postoperative complication Medicare Database Orthopedic surgery RD701-811 Brandon L. Morris Jack M. Ayres Daniel Reinhardt Armin Tarakemeh Scott Mullen J. Paul Schroeppel Bryan G. Vopat Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population
description	Abstract Purpose Despite increased utilization of unicompartmental knee arthroplasty (UKA) for unicompartmental knee osteoarthritis, outcomes in Medicare patients are not well-reported. The purpose of this study is to analyze practice patterns and outcome differences between UKA and TKA in the Medicare population. It is hypothesized that UKA utilization will have increased over the course of the study period and that UKA will be associated with reduced opioid use and lower complication rates compared to TKA. Methods Using PearlDiver, the Humana Claims dataset and the Medicare Standard Analytic File (SAF) were analyzed. Patients who underwent UKA and TKA were identified by CPT codes. Postoperative complications were identified by ICD-9/ICD-10 codes. Opioid use was analyzed by the number of days patients were prescribed opioids postoperatively. Survivorship was defined as conversion to TKA. Results In the Humana dataset, 7,808 UKA and 150,680 TKA patients were identified. 8-year survivorship was 87.7% (95% CI [0.861,0.894]). Postoperative opioid use was significantly higher after TKA (186.1 days) compared to UKA (144.7 days) (p < 0.01, Δ = 41.1, 95% CI = [30.41, 52.39]). In the SAF dataset, 20,592 UKA patients and 110,562 TKA patients were identified. Survivorship was highest in patients > 80 years old and lowest in patients < 70 years old. In both datasets, postoperative complication rates were higher in TKA patients compared to UKA patients in nearly all categories. Conclusions UKA represents an increasingly utilized treatment for osteoarthritis in the Medicare population and may be comparatively advantageous to TKA due to reduced opioid use and complication rates after surgery. Level of evidence Level III
format	article
author	Brandon L. Morris Jack M. Ayres Daniel Reinhardt Armin Tarakemeh Scott Mullen J. Paul Schroeppel Bryan G. Vopat
author_facet	Brandon L. Morris Jack M. Ayres Daniel Reinhardt Armin Tarakemeh Scott Mullen J. Paul Schroeppel Bryan G. Vopat
author_sort	Brandon L. Morris
title	Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population
title_short	Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population
title_full	Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population
title_fullStr	Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population
title_full_unstemmed	Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population
title_sort	unicompartmental knee arthroplasty: a pearldiver study evaluating complications rates, opioid use and utilization in the medicare population
publisher	SpringerOpen
publishDate	2021
url	https://doaj.org/article/a57361fbc00c4052a10fb42f3327d57e
work_keys_str_mv	AT brandonlmorris unicompartmentalkneearthroplastyapearldiverstudyevaluatingcomplicationsratesopioiduseandutilizationinthemedicarepopulation AT jackmayres unicompartmentalkneearthroplastyapearldiverstudyevaluatingcomplicationsratesopioiduseandutilizationinthemedicarepopulation AT danielreinhardt unicompartmentalkneearthroplastyapearldiverstudyevaluatingcomplicationsratesopioiduseandutilizationinthemedicarepopulation AT armintarakemeh unicompartmentalkneearthroplastyapearldiverstudyevaluatingcomplicationsratesopioiduseandutilizationinthemedicarepopulation AT scottmullen unicompartmentalkneearthroplastyapearldiverstudyevaluatingcomplicationsratesopioiduseandutilizationinthemedicarepopulation AT jpaulschroeppel unicompartmentalkneearthroplastyapearldiverstudyevaluatingcomplicationsratesopioiduseandutilizationinthemedicarepopulation AT bryangvopat unicompartmentalkneearthroplastyapearldiverstudyevaluatingcomplicationsratesopioiduseandutilizationinthemedicarepopulation
_version_	1718429247685525504

Unicompartmental knee arthroplasty: A PearlDiver study evaluating complications rates, opioid use and utilization in the Medicare population

Ejemplares similares