Background
Methods
Patients
Operation
Propensity score matching method
Outcomes
Statistical analyses
Results
Propensity score matching
Pre-match | Post-match | |||||||
---|---|---|---|---|---|---|---|---|
1:4 | HD (21 knees) | non-HD (706 knees) | p-value | Standardized difference | HD (21 knees) | non-HD (71 knees) | p-value | Standardized difference |
Age | 66.9 ± 9.3 | 73.4 ± 8.6 | 0.001 | 0.124 | 66.9 ± 9.3 | 68.5 ± 12.2 | 0.312 | 0.033 |
Gender (Female) | 17 (81.0) | 569 (80.6) | 1.000 | 0.009 | 17 (81.0) | 58 (81.7) | 1.000 | 0.0189 |
BMI (kg/m2) | 22.74 ± 4.85 | 25.78 ± 3.95 | 0.001 | 0.164 | 22.74 ± 4.85 | 23.48 ± 4.44 | 0.446 | 0.044 |
Preoperative Hb | 11.88 ± 1.35 | 12.54 ± 1.42 | 0.004 | 0.074 | 11.88 ± 1.35 | 11.81 ± 1.45 | 0.849 | 0.007 |
Preoperative Plt | 21.25 ± 6.05 | 21.90 ± 6.6 | 0.829 | 0.041 | 21.25 ± 6.05 | 21.80 ± 8.17 | 0.919 | 0.034 |
Preoperative Alb | 3.74 ± 0.32 | 3.98 ± 0.38 | 0.002 | 0.084 | 3.74 ± 0.32 | 3.732 ± 0.48 | 0.685 | 0.002 |
Preoperative AKSS Knee score | 44.9 ± 18.8 | 46.2 ± 16.0 | 0.760 | 0.037 | 44.9 ± 18.8 | 46.6 ± 16.7 | 0.787 | 0.049 |
Preoperative AKSS Function score | 30.7 ± 20.9 | 41.5 ± 19.9 | 0.018 | 0.328 | 30.7 ± 20.9 | 33.0 ± 21.4 | 0.562 | 0.084 |
Osteoarthritis | 14 (66.7) | 617 (87.4) | 0.014 | 0.508 | 14 (66.7) | 47 (66.2) | 1.000 | 0.010 |
Rheumatoid arthritis | 6 (28.6) | 74 (10.5) | 0.021 | 0.469 | 6 (28.6) | 20 (28.2) | 1.000 | 0.009 |
Osteonecrosis | 1 (4.8) | 10 (1.4) | 0.277 | 0.194 | 1 (4.8) | 4 (5.6) | 1.000 | 0.039 |
Post-traumatic arthritis | 0 (0.0) | 5 (0.7) | 1.000 | 16.724 | 0 (0.0) | 0 (0.0) | N/A | N/A |
Post-osteotomy arthritis | 0 (0.0) | 4 (0.6) | 1.000 | 18.678 | 0 (0.0) | 0 (0.0) | N/A | N/A |
Diabetes mellitus | 5 (23.8) | 114 (16.2) | 0.366 | 0.192 | 5 (23.8) | 17 (23.9) | 1.000 | 0.003 |
Hypertension | 8 (38.1) | 381 (54.0) | 0.184 | 0.323 | 8 (38.1) | 23 (32.4) | 0.612 | 0.120 |
Cancer | 1 (4.8) | 53 (7.5) | 1.000 | 0.115 | 1 (4.8) | 4 (5.6) | 1.000 | 0.039 |
Stroke | 1 (4.8) | 63 (8.9) | 1.000 | 0.165 | 1 (4.8) | 1 (1.4) | 0.406 | 0.195 |
Cardiac disease | 3 (14.3) | 107 (15.2) | 1.000 | 0.025 | 3 (14.3) | 7 (9.8) | 0.690 | 0.136 |
Chronic respiratory disease | 1 (4.8) | 5 (0.7) | 0.162 | 0.250 | 1 (4.8) | 3 (4.2) | 1.000 | 0.026 |
Psychiatric disease | 0 (0.0) | 19 (2.7) | 1.000 | 8.506 | 0 (0.0) | 0 (0.0) | N/A | N/A |
Spinal disease | 2 (9.5) | 51 (7.2) | 0.661 | 0.083 | 2 (9.5) | 5 (7.0) | 0.657 | 0.090 |
Osteoporosis | 2 (9.5) | 32 (4.5) | 0.257 | 0.196 | 2 (9.5) | 5 (7.0) | 0.657 | 0.090 |
Venous thromboembolism | 0 (0.0) | 1 (0.1) | 1.000 | 37.770 | 0 (0.0) | 0 (0.0) | N/A | N/A |
Chronic liver disease | 1 (4.8) | 28 (4.0) | 0.580 | 0.039 | 1 (4.8) | 5 (7.0) | 1.000 | 0.097 |
Anemia | 6 (28.6) | 87 (12.3) | 0.041 | 0.411 | 6 (28.6) | 21 (29.6) | 1.000 | 0.022 |
Intragroup comparisons
Pre-operation | Two year follow-up | Last follow-up | p-valuea | p-valueb | p-valuec | |
---|---|---|---|---|---|---|
HD group | ||||||
AKSS Knee Score | 44.9 ± 18.8 (10–72) | 95.0 ± 9.8 (72–100) | 95.4 ± 7.7 (72–100) | < 0.0001 | < 0.0001 | 0.7684 |
AKSS Function Score | 30.7 ± 20.9 (0–70) | 73.1 ± 27.2 (0–100) | 66.9 ± 33.0 (0–100) | < 0.0001 | < 0.0001 | 0.1567 |
non-HD group | ||||||
AKSS Knee Score | 46.6 ± 16.7 (0–80) | 96.8 ± 5.5 (69–100) | 97.6 ± 3.4 (83–100) | < 0.0001 | < 0.0001 | 0.2696 |
AKSS Function Score | 33.0 ± 21.4 (0–70) | 78.9 ± 18.8 (15–100) | 79.2 ± 18.2 (15–100) | < 0.0001 | < 0.0001 | 0.8616 |
Comparison between groups
HD group | non-HD group | p-value | |
---|---|---|---|
AKSS-knee score at the two year follow-up | 95.0 ± 9.8 (72–100) | 96.8 ± 5.5 (69–100) | 0.4641 |
Pain | 48.1 ± 6.0 (30–50) | 49.2 ± 2.8 (30–50) | 0.7978 |
Total range of flexion | 23.8 ± 3.6 (12–25) | 24.2 ± 1.9 (14–25) | 0.3893 |
Stability | 25.0 ± 0.0 (25–25) | 25.0 ± 0.0 (25–25) | 1.0000 |
Flexion contracture | 1.2 ± 3.3 (0–15) | 0.5 ± 0.9 (0–2) | 0.7817 |
Extension lag | 0.7 ± 1.8 (0–5) | 0.5 ± 2.7 (0–20) | 0.1175 |
Alignment | 0.0 ± 0.0(0–0) | 0.5 ± 2.3 (0–15) | 0.2653 |
Increase from preoperative score | 50.1 ± 19.3 (26–90) | 50.2 ± 17.1 (14–91) | 0.8633 |
AKSS-function score at the two year follow-up | 73.1 ± 27.2 (0–100) | 78.9 ± 18.8 (15–100) | 0.6314 |
Walking | 41.4 ± 14.2 (0–50) | 45.8 ± 7.9 (20–50) | 0.2368 |
Stairs | 33.3 ± 12.8 (0–50) | 36.0 ± 10.8 (0–50) | 0.6052 |
Walking aids used | 2.1 ± 4.6 (0–20) | 3.0 ± 4.9 (0–20) | 0.2639 |
Increase from preoperative score | 42.4 ± 29.7 (− 35–90) | 45.9 ± 20.6 (− 20–90) | 0.8923 |
AKSS-knee score at the last follow-up | 95.4 ± 7.7 (72–100) | 97.6 ± 3.4 (83–100) | 0.9048 |
Pain | 48.8 ± 3.1 (40–50) | 49.3 ± 1.8 (45–50) | 0.8595 |
Total range of flexion | 23.5 ± 3.6(12–25) | 24.2 ± 2.4 (8–25) | 0.8083 |
Stability | 24.5 ± 1.5 (20–25) | 25.0 ± 0.0 (25–25) | 0.0089 |
Flexion contracture | 1.2 ± 3.3 (0–15) | 0.5 ± 1.0 (0–5) | 0.6166 |
Extension lag | 0.2 ± 1.1 (0–5) | 0.07 ± 0.6 (0–5) | 0.3572 |
Alignment | 0.0 ± 0.0(0–0) | 0.3 ± 1.5 (0–9) | 0.3409 |
Increase from preoperative score | 50.5 ± 18.5 (27–90) | 51.0 ± 16.7 (20–98) | 0.7979 |
AKSS-function score at the last follow-up | 66.9 ± 33.0 (0–100) | 79.2 ± 18.2(15–100) | 0.2674 |
Walking | 38.6 ± 16.5 (0–50) | 46.1 ± 7.7 (20–50) | 0.0330 |
Stairs | 30.0 ± 16.1 (0–50) | 36.1 ± 9.9 (0–50) | 0.3110 |
Walking aids used | 2.1 ± 4.6 (0–20) | 3.0 ± 4.6 (0–20) | 0.2640 |
Increase from preoperative score | 36.2 ± 34.3 (− 35–90) | 46.1 ± 20.0 (10–85) | 0.3269 |
Postoperative length of stay (days) | 25.4 ± 30.8 (9–154) | 17.2 ± 3.4 (12–32) | 0.4968 |
Postoperative follow-up period (months) | 42.2 ± 25.2 (24–98) | 62.7 ± 30.4 (25–150) | 0.0047 |
Operating time (minutes) | 83.8 ± 14.5 (64–109) | 80.4 ± 20.6 (46–139) | 0.2391 |
Anesthesia time (minutes) | 120.3 ± 17.3 (90–155) | 117.8 ± 28.1 (67–214) | 0.3473 |
Hemoglobin count on the first postoperative day (g/dL) | 10.4 ± 1.5 (7.8–13.2) | 10.1 ± 1.2 (7.2–13.2) | 0.4453 |
Hemoglobin count at one week postoperation (g/dL) | 9.3 ± 1.2 (7–11.2) | 9.7 ± 1.3 (6.8–14.1) | 0.3147 |
Platelet count on the first postoperative day (× 109/L) | 18.2 ± 6.1 (8.4–31.3) | 17.9 ± 6.8 (5.3–34.0) | 0.8269 |
Platelet count at one week postoperation (× 109/L) | 23.2 ± 7.0 (9.1–38.1) | 25.2 ± 8.6 (3.0–50.2) | 0.2764 |
Volume of allogenic blood transfusion (mL) | 1.1 ± 3.2 (0–14) | 0.08 ± 0.5 (0–4) | 0.0077 |
HD group | non-HD group | p-value | Odds ratio | 95% CI | |
---|---|---|---|---|---|
Any complications within the time period | |||||
0–12 months | 13 (61.9) | 20 (28.2) | 0.0085 | 4.14 | 1.49–11.51 |
12–24 months | 7 (33.3) | 7 (9.9) | 0.0149 | 4.57 | 1.38–15.13 |
0–1 month | 10 (47.6) | 12 (16.9) | 0.0074 | 4.47 | 1.55–12.87 |
1–2 months | 2 (9.5) | 1 (1.4) | 0.1293 | 7.37 | 0.63–85.68 |
2–3 months | 0 (0.0) | 0 (0.0) | N/A | N/A | N/A |
3–4 months | 2 (9.5) | 2 (2.8) | 0.2227 | 3.63 | 0.48–27.50 |
4–5 months | 0 (0.0) | 0 (0.0) | N/A | N/A | N/A |
5–6 months | 2 (9.5) | 1 (1.4) | 0.1293 | 7.37 | 0.63–85.68 |
6–7 months | 0 (0.0) | 0 (0.0) | N/A | N/A | N/A |
7–8 months | 1 (4.8) | 2 (2.8) | 0.5449 | 1.73 | 0.15–20.02 |
8–9 months | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
9–10 months | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
10–11 months | 1 (4.8) | 1 (1.4) | 0.4064 | 3.50 | 0.21–58.48 |
11–12 months | 2 (9.5) | 4 (5.6) | 0.6166 | 1.76 | 0.30–10.37 |
12–13 months | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
13–14 months | 0 (0.0) | 1 (1.4) | 1.0000 | N/A | N/A |
14–15 months | 0 (0.0) | 0 (0.0) | N/A | N/A | N/A |
15–16 months | 0 (0.0) | 1 (1.4) | 1.0000 | N/A | N/A |
16–17 months | 0 (0.0) | 1 (1.4) | 1.0000 | N/A | N/A |
17–18 months | 2 (9.5) | 0 (0.0) | 0.0502 | N/A | N/A |
18–19 months | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
19–20 months | 0 (0.0) | 0 (0.0) | N/A | N/A | N/A |
20–21 months | 0 (0.0) | 0 (0.0) | N/A | N/A | N/A |
21–22 months | 2 (9.5) | 2 (2.8) | 0.2227 | 3.63 | 0.48–27.50 |
22–23 months | 0 (0.0) | 1 (1.4) | 1.0000 | N/A | N/A |
23–24 months | 2 (9.5) | 2 (2.8) | 0.2227 | 3.63 | 0.48–27.50 |
0–24 months | 13 (61.9) | 25 (35.2) | 0.0429 | 2.99 | 1.09–8.18 |
Beyond two years | 12 (57.1) | 21 (29.6) | 0.0364 | 3.17 | 1.16–8.66 |
HD group | non-HD group | p-value | Odds ratio | 95% CI | |
---|---|---|---|---|---|
Anemia requiring allogenic blood transfusion | 4 (19.1) | 2 (2.8) | 0.0230 | 8.12 | 1.37–48.06 |
Shunt failure | 6 (28.6) | 0 (0.0) | < 0.0001 | N/A | N/A |
Carpal tunnel syndrome | 3 (14.3) | 0 (0.0) | 0.0106 | N/A | N/A |
Severe aortic stenosis | 3 (14.3) | 0 (0.0) | 0.0106 | N/A | N/A |
Periprosthetic joint infection | 1 (4.8) | 3 (4.2) | 1.0000 | 0.88 | 0.09–8.96 |
Ileus | 2 (9.5) | 0 (0.0) | 0.0502 | N/A | N/A |
Pressure ulcer | 3 (14.3) | 2 (2.8) | 0.0763 | 0.17 | 0.03–1.12 |
Hypoglycemia | 2 (9.5) | 0 (0.0) | 0.0502 | N/A | N/A |
Hematoma around the knee | 2 (9.5) | 2 (2.8) | 0.2227 | 0.28 | 0.04–2.09 |
Shoulder osteoarthritis | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Pneumomycosis | 2 (9.5) | 0 (0.0) | 0.0502 | N/A | N/A |
Vertebral compression fracture | 2 (9.5) | 0 (0.0) | 0.0502 | N/A | N/A |
Erythema induratum of Bazin | 2 (9.5) | 0 (0.0) | 0.0502 | N/A | N/A |
Femoral neck fracture | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Acute cholecystitis | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Intracardiac thrombus | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Infective endocarditis | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Lumber spinal stenosis | 2 (9.5) | 1 (1.4) | 0.1293 | 0.14 | 0.01–1.58 |
Transient ischemic attack | 2 (9.5) | 1 (1.4) | 0.1293 | 0.14 | 0.01–1.58 |
Subconjunctival hemorrhage | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Posterior interosseous nerve palsy | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Cervical spondylotic myelopathy | 2 (9.5) | 0 (0.0) | 0.0502 | N/A | N/A |
Sudden cardiac arrest | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Death | 2 (9.5) | 1 (1.4) | 0.1293 | 0.14 | 0.01–1.58 |
Distal radial fracture | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Colon carcinoma in adenoma | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Acute myocardial infarction | 1 (4.8) | 1 (1.4) | 0.4064 | 0.29 | 0.02–4.77 |
Urinary tract infection | 2 (9.5) | 0 (0.0) | 0.0502 | N/A | N/A |
Sepsis | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Pneumonia | 1 (4.8) | 2 (2.8) | 0.5449 | 0.58 | 0.05–6.73 |
Ascending colonic diverticular bleeding | 1 (4.8) | 0 (0.0) | 0.2283 | N/A | N/A |
Gastric ulcer | 1 (4.8) | 1 (1.4) | 0.4064 | 0.29 | 0.02–4.77 |