Comparison of The Clinical Outcomes and Safety after One_stage Bilateral and Two_stage Bilateral Total knee Arthroplasty

HUANG Jian

Abstract：Objective To compare the clinical outcomes and safety of patients with simultaneous bilateral degenerative os_teoarthritis treatment of one_stage bilateral and two_stage bilateral total knee arthroplasty. Methods Retrospective analysis of clinical data of 93 patients with simultaneous bilateral knee degenerative osteoarthritis were treated with one_stage bilateral(A group)and two_stage bilateral(group B)TKA in our hospital from April 2005 to April 2012. The A group had 54 patients (male 5;female 49). The mean age was(65. 8 ± 6. 5)years;The B group had 39 patients(male 6;female 33). The mean age was(66. 1 ± 7. 7)years. Two groups of patients were compared with following data,including length of hospital stay,the total a_mount of bleeding,occult bleeding,blood transfusion,drainage,postoperative hemoglobin,hospital costs,and postoperative out_comes(the KSS score,range of motion,and complications). The total amount of blood loss and occult bleeding was calculated according to Gross equation. Results There were statistically significant differences in the term of postoperative drainage, blood transfusion,the total amount of bleeding,occult bleeding,length of hospital stay,and hospital costs(P < 0. 05);There were no statistically significant differences in the term of postoperative KSS score and ROM(P > 0. 05). But the postoperative KSS score in both groups were improved significantly compared with before KSS score(P < 0. 05);There were no statistically significant differences in the term of postoperative hematoma ,DVT ,incidence of poor wound healing ,and infection rates( P >0. 05). But overall incidence of postoperative complications in A group was higher than B group(P < 0. 05). Conclusion One_stage bilateral TKA had an increased surgical trauma,a higher incidence of postoperative complications,which may be lead to a high risk of periprosthetic infection. We suggest that if patients with bilateral degenerative arthritis,who associated with younger age,less preoperative comorbidities and good physical,may be considered one_stage bilateral TKA.