{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:45:51Z","timestamp":1785887151581,"version":"3.56.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthroplasty"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Use of cementless total knee arthroplasty (TKA) has increased in recent years, but contemporary short-term administrative comparisons with cemented fixation remain limited. This study compared 90-day readmission and early postoperative complications after ICD-10-PCS coding-defined cementless-category versus cemented-category primary TKA using a large U.S. administrative readmission database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The 2020\u20132022 Healthcare Cost and Utilization Project Nationwide Readmissions Database (NRD) was queried for adults undergoing elective unilateral primary TKA for osteoarthritis. Only cases performed on hospital day 0 using common cemented and cementless ICD-10-PCS procedure codes were included. Fixation category was defined using ICD-10-PCS administrative procedure coding and was analyzed as coding-defined cementless-category versus cemented-category primary TKA. Non-elective admissions, bilateral procedures, revision or reoperation cases, fracture-, malignancy-, infection-, and COVID-19-related admissions, and index discharges after September were excluded. Readmissions involving contralateral knee arthroplasty were also excluded. Propensity-score matching was performed on the unweighted analytic sample, and DISCWT was applied after matching to generate weighted national estimates and proportions. The primary outcome was 90-day all-cause readmission. Secondary outcomes included intraoperative fracture, blood loss anemia, blood transfusion, stratified in-hospital complications, readmission burden, grouped primary causes of readmission, and grouped principal procedures performed during readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 1:1 matched analytic cohort included 23,140 unweighted admissions in each coding-defined fixation category. After applying DISCWT, these corresponded to weighted national estimates of 40,490 cemented-category and 40,501 cementless-category primary TKA admissions. Coding-defined cementless-category TKA was associated with a lower weighted 90-day readmission proportion compared with cemented-category TKA (5.17% vs 5.76%; OR 0.89, 95% CI 0.84\u20130.95;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), as well as lower weighted proportions of blood loss anemia (11.28% vs 13.13%; OR 0.84, 95% CI 0.81\u20130.88;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and any in-hospital complication (13.55% vs 15.36%; OR 0.86, 95% CI 0.83\u20130.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Intraoperative fracture was more frequent in the cementless-category group (0.30% vs 0.18%; OR 1.67, 95% CI 1.25\u20132.23;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Blood transfusion rates were comparable between cohorts. Among readmitted patients, grouped primary readmission diagnoses and grouped principal procedures were heterogeneous and included infectious, wound-related, thromboembolic, cardiopulmonary, gastrointestinal, renal\/urinary, mechanical\/fracture-related, and other medical categories. Knee revision-related procedures represented only a minority of readmission procedures. In the revised age-centered interaction analysis, the fixation-category association at age 70\u00a0years was not statistically significant, while the fixation-category by age interaction remained significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this U.S. nationwide propensity-matched administrative analysis of elective unilateral primary TKA, coding-defined cementless-category and cemented-category admissions demonstrated modest differences in selected early complications and 90-day readmission patterns. These findings characterize short-term administrative outcomes and should be interpreted in the context of coding-based fixation classification and the absence of implant-level, radiographic, functional, and long-term survivorship data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Levels of Evidence<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s42836-026-00418-2","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T23:01:22Z","timestamp":1785884482000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ninety-day readmission and early complications after coding-defined cementless-category versus cemented-category primary total knee arthroplasty"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1538-5347","authenticated-orcid":false,"given":"David","family":"Maman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaniv","family":"Steinfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaron","family":"Berkovich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"418_CR1","doi-asserted-by":"publisher","unstructured":"Shichman I, Roof M, Askew N, Nherera L, Rozell JC, Seyler TM, Schwarzkopf R. 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