ABSTRACT
This study evaluates return to work and revision rates for medial unicondylar knee arthroplasty (UKA) in a high-demand military cohort. Patient demographic and clinical variables were isolated from the medical records of active-duty military servicemembers with at least 2 years of postoperative follow-up and correlated with return to work, medial UKA survivorship, and perioperative complications. The medial UKA annual revision rate was calculated as the percentage of implants revised per observed component year. A total of 39 servicemembers underwent 46 primary medial UKAs (32 unilateral and 7 bilateral) with a mean follow-up of 3.9 (2.0-6.6) years. At a minimum of 2 years postoperatively, 33 (85%) servicemembers returned to military service or successfully completed their service obligation. Older servicemembers (odds ratio [OR] = 0.67; 95% confidence interval [CI]: 0.45, 0.99) had a significantly decreased OR for knee-related medical separation. Nine servicemembers (20%) had conversion to TKA at an average of 2.4 (range, 0.6-5.6) years with a medial UKA annual revision rate of 5%. When compared with Navy/Air Force, Army/Marine servicemembers had an increased TKA conversion rate (OR = 5.40; 95% CI: 1.13, 25.81). Older age decreased the likelihood of medical separation and Army/Marines service was the sole risk factor associated with conversion to TKA. The level of evidence is IV, therapeutic case series.
Subject(s)
Arthroplasty, Replacement, Knee , Knee Prosthesis , Military Personnel , Osteoarthritis, Knee , Humans , Reoperation , Treatment Outcome , Knee Joint/surgery , Osteoarthritis, Knee/surgery , Retrospective StudiesABSTRACT
UNLABELLED: This investigation sought to determine occupational outcomes after total knee arthroplasty (TKA) in a high-demand cohort. A total of 159 military servicemembers underwent 181 primary TKAs with mean follow-up of 4.1 (range, 2.0-6.6) years. Approximately 18% of servicemembers underwent medical separation from the military due to TKA-related limitations, and age <45 years (OR=2.36; 95% CI: 1.14, 4.90) was established as the significant risk factor. Twenty servicemembers (12.6%) performed postoperative combat deployments, with age <45 years (OR=3.10; 95% CI: 1.29, 7.47) or combat arms designation (OR=2.75; 95% CI: 1.13, 6.73) associated with higher rates of deployment. Nine revision TKAs (5.0%) were performed at an average of 1.9 years. Following TKA, 82% of servicemembers remained on active-duty or completed their military service. LEVEL OF EVIDENCE: IV.