Columbia University Medical Center, Department of Orthopaedic Surgery, New York, NY.
J Arthroplasty. 2021 Mar;36(3):905-909. doi: 10.1016/j.arth.2020.09.007. Epub 2020 Sep 12.
Prolonged operative duration is an independent risk factor for postoperative complications in many orthopedic procedures ranging from shoulder arthroscopy to total hip and knee arthroplasties. It has not been well studied in unicompartmental knee arthroplasty (UKA). The purpose of this study is to assess the effect of operative duration on complications after UKA.
Using the American College of Surgeons National Surgical Quality Improvement Program registry, we identified all primary unilateral UKAs from 2005 to 18. Patients were divided into three cohorts based on the operative duration: < 90 minutes, between 90 and 120 minutes, and >120 minutes. Baseline patient and operative demographics (age, gender, etc.) and thirty-day complications were compared using bivariate analysis. Multivariate analysis was used to assess the independent effect of operative duration on postoperative outcomes after adjusting for differences in baseline characteristics.
We identified 11,806 patients who underwent primary UKA from 2005 to 18. There was no difference in the "any complication" rate between cohorts. However, operative duration >120 minutes was associated with a significantly higher likelihood of reoperation (odds ratio [OR] 2.02, 95% confidence interval [CI]: 1.15-3.57, P = .015), non-home discharge (OR: 2.14, CI: 1.65-2.77, P < .001), surgical site infection (OR: 1.76, CI: 1.03-3.01, P = .038), and blood transfusions (OR: 3.23, CI: 1.44-7.22, P = .004) when compared with operative duration <90 minutes. There was no difference in mortality rates.
Increased operative duration greater than 2 hours in primary UKA is associated with an increased risk of non-home discharge, surgical site infection, reoperation, and blood transfusion.
在从肩关节镜检查到全髋关节和膝关节置换术等多种骨科手术中，手术时间延长是术后并发症的一个独立危险因素。在单髁膝关节置换术（UKA）中，这一问题尚未得到很好的研究。本研究旨在评估手术时间对 UKA 后并发症的影响。
我们使用美国外科医师学会国家手术质量改进计划登记处，确定了 2005 年至 2018 年所有初次单侧 UKA 患者。患者根据手术时间分为三组：<90 分钟、90-120 分钟和>120 分钟。使用双变量分析比较基线患者和手术人口统计学特征（年龄、性别等）和 30 天并发症。使用多变量分析，在校正基线特征差异后，评估手术时间对术后结果的独立影响。
我们确定了 2005 年至 2018 年间接受初次 UKA 的 11806 名患者。三组间“任何并发症”发生率无差异。然而，手术时间>120 分钟与再手术的可能性显著增加相关（优势比 [OR] 2.02，95%置信区间 [CI]：1.15-3.57，P =.015）、非家庭出院（OR：2.14，CI：1.65-2.77，P <.001）、手术部位感染（OR：1.76，CI：1.03-3.01，P =.038）和输血（OR：3.23，CI：1.44-7.22，P =.004）与手术时间<90 分钟相比。死亡率无差异。
在初次 UKA 中，手术时间超过 2 小时与非家庭出院、手术部位感染、再手术和输血的风险增加相关。
