Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
J Knee Surg. 2021 Aug;34(10):1138-1141. doi: 10.1055/s-0040-1702189. Epub 2020 Mar 4.
Total knee replacement (TKR) and unicompartmental knee replacement (UKR) are successful procedures for patients with knee arthritis. While strict criteria were proposed early on for UKR, some surgeons have expanded these indications to include younger and heavier patients. The purpose of this study is to analyze trends in usage of TKR and UKR in the United States. This retrospective study analyzed an insurance administrative dataset. Patients who underwent primary TKR and UKR were identified via current procedural terminology codes. Information on incidence, obesity, use of computer navigation, and surgical setting were collected. We analyzed 7,194 UKRs and 128,849 TKRs performed from 2007 to 2016. Prevalence of obesity in both groups increased over the study period. Utilization of computer navigation increased for UKR but declined for TKR. The rate of outpatient procedures significantly increased for UKR but remained constant for TKR. Both TKR and UKR are being performed at increasing rates and on heavier patients. The use of computer navigation and outpatient surgical setting is increasing for UKR but not for TKR. Knowledge of these trends is important for surgeons and policy-makers to help inform surgical indications and resource allocation.
全膝关节置换术（TKR）和单髁膝关节置换术（UKR）是治疗膝关节关节炎患者的成功手术。虽然 UKR 早期提出了严格的适应证标准，但一些外科医生已将这些适应证扩大到包括年轻和体重大的患者。本研究旨在分析美国 TKR 和 UKR 使用的趋势。这项回顾性研究分析了一个保险管理数据集。通过当前操作术语代码识别接受初次 TKR 和 UKR 的患者。收集了发病率、肥胖、计算机导航使用和手术环境的信息。我们分析了 2007 年至 2016 年期间进行的 7194 例 UKR 和 128849 例 TKR。两组的肥胖患病率在研究期间均增加。UKR 中计算机导航的使用率增加，但 TKR 的使用率下降。UKR 的门诊手术比例显著增加，但 TKR 保持不变。TKR 和 UKR 的应用率均呈上升趋势，且应用于体重更大的患者。UKR 中计算机导航和门诊手术环境的使用正在增加，但 TKR 并非如此。了解这些趋势对于外科医生和政策制定者来说很重要，可以帮助确定手术适应证和资源分配。
