A comparison of effects of different surgical methods in bilateral total knee arthroplasty
LI Zu-tao
XU Jiang-bo
XU Wan-long
MIAO Xiao-gang
YUAN Hong
Abstract：Objective To analyze the influence factors and compare the curative effects of simultaneous bilateral total knee arthroplasty ( TKA ) in 1 hospitalization period, staggered bilateral TKA in 1 hospitalization period or staggered bilateral TKA in 2 hospitalization periods.Methods From 2003 to 2011, 378 patients undergoing simultaneous and staged bilateral TKA were enrolled in the study, among whom 352 patients were followed up for at least 2 years. All the patients were divided into 3 groups based on the surgical intervals, including group A of simultaneous bilateral TKA in 1 hospitalization period (n=128 ), group B of staggered bilateral TKA in 1 hospitalization period (n=118 ) and group C of staggered bilateral TKA in 2 hospitalization periods (n=106 ). A retrospective review of each group was conducted to compare the preoperative factors, postoperative complications and differences of curative effects.Results The average age in group A was ( 65.0±6.8 ) years old, who were older than ( 70.8±7.6 ) years old in group B and ( 70.2±7.7 ) years old in group C, and the differences were statistically signiifcant (P<0.05 ). The differences in the average age between group B and group C were not statistically signiifcant (P>0.05 ). The preoperative complications of group A were less than that in group B and group C, and the differences were statistically signiifcant (P<0.05 ). The total duration of hospitalization was ( 13.6±3.2 ) d in group A, which was shorter than ( 22.5±6.2 ) d in group B and ( 27.4±7.3 ) d in group C, and the differences were statistically signiifcant (P<0.05 ). The differences in the total duration of hospitalization between group B and group C were not statistically significant (P>0.05 ). The perioperative blood transfusion volume in group A was ( 732.4±375.1 ) ml, which was larger than ( 501.7±207.2 ) ml in group B and ( 510.9±208.8 ) ml in group C, and the differences were statistically signiifcant (P<0.05 ). The differences in the perioperative blood transfusion volume between group B and group C were not statistically signiifcant (P>0.05 ). The difference value between the preoperative Hospital for Special Surgery ( HSS ) score and the postoperative score was ( 32.9±12.3 ), ( 33.2±12.8 ) and ( 33.4±11.9 ) respectively in 3 groups. The total perioperative blood loss was ( 1071.6±112.3 ) ml, ( 986.4±121.7 ) ml and ( 1036.1±98.7 ) ml, and the total operation time was ( 171.9±30.1 ) min, ( 183.7±32.2 ) min and ( 182.7±32.4 ) min respectively. The differences in the postoperative complication and mortality rate were not statistically significant among the 3 groups (P>0.05 ). Conclusions With well preoperative preparation and reasonable patient selection, the same long-term curative results can be achieved in simultaneous bilateral TKA in 1 hospitalization period as in staggered bilateral TKA in 1 hospitalization period or in staggered bilateral TKA in 2 hospitalization periods.
Keywords：Knee jointKnee prosthesisArthroplastyreplacementkneeSurgical proceduresoperativeTreatment protocols
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 861-864 )