Conversion total knee arthroplasty (TKA) is suggested to incur similar complication rates to revision arthroplasties. However, current billing codes do not allow for the differentiation between this operation and primary TKAs. Therefore, the purpose of this study was to compare outcomes of these two surgeries, as well as revision TKAs. Specifically, we analyzed (1) medical complications, (2) surgical complications, and (3) revision rates at 90 days and 1 year. We queried a national, all-payer database to identify patients who underwent TKA without prior implants (n = 1,358,767), required conversion TKA (n = 15,378), and who underwent revision TKA (n = 33,966) between January 1, 2010, and April 30, 2020. Conversion TKA patients (prior implant removal) were identified using the Current Procedural Terminology (CPT) codes. Outcomes studied included 30-day readmission rates and 90-day, as well as 1-year, medical and surgical complications. Conversion TKAs had greater 30-day readmission rates and incidences of most of the complications studied when compared with primary TKAs. The majority of outcomes when comparing between primary, conversion, and revision TKAs were significantly different (p < 0.01). In contrast, conversion TKA complications were similar to revision TKA. Conversion TKAs have higher postoperative complications than primary TKAs and share more similarities with revision TKAs. Thus, the lack of billing codes differentiating conversion and primary TKAs creates a challenge for orthopaedic surgeons.

建议转换全膝关节置换术（TKA）与翻修关节置换术产生相似的并发症发生率。然而，当前的计费代码不允许区分此操作和主要 TKA。因此，本研究的目的是比较这两种手术以及翻修全膝关节置换术的结果。具体来说，我们分析了 (1) 医疗并发症、(2) 手术并发症和 (3) 90 天和 1 年的翻修率。我们查询了一个全国性的全付费者数据库，以确定在 2010 年 1 月 1 日至 2010 年 1 月 1 日期间接受过 TKA 治疗（ n  = 1,358,767）、需要转换 TKA（n  = 15,378）以及接受翻修 TKA（n = 33,966）的患者。 2020 年 4 月 30 日。使用当前程序术语 (CPT) 代码识别转换 TKA 患者（植入物移除之前）。研究结果包括 30 天的再入院率和 90 天以及 1 年的内科和手术并发症。与初次 TKA 相比，转换 TKA 的 30 天再入院率和大多数研究并发症的发生率更高。初次、转换和翻修 TKA 之间的比较时，大多数结果存在显着差异 ( p  < 0.01)。相比之下，转换型 TKA 并发症与翻修型 TKA 相似。转换型 TKA 比初次 TKA 具有更高的术后并发症，并且与翻修型 TKA 有更多相似之处。因此，缺乏区分转换和初次全膝关节置换的计费代码给骨科医生带来了挑战。