Article
One-stage bilateral versus unilateral total knee arthroplasty
Search Medline for
Authors
-
B. Rausch
- Baumann-Klinik, Karl-Olga-Krankenhaus, Orthopädie, Stuttgart
-
S. Schmitt
- Stuttgart
-
C. Trepte
- Stuttgart
| Published: | June 13, 2005 |
|---|
Outline
Text
Introduction
The timing of the operative treatment for patients with degenerative changes in both knees remains controversial. Higher occurrence rates for deep venous thrombosis and cardiopulmonary complications are the reasons against, decreased hospitalization, reduced cost, and reduced anesthetic risk are the reasons for a one-stage bilateral total knee arthroplasty (TKA).
The aim of this study was to determine if any differences existed in our patients.
Material and methods
Between May 2001 and November 2004 95 patients underwent 190 one-stage sequential bilateral TKAs under the same anesthesia. A group of 95 other patients who underwent unilateral primary TKA during the same time interval were selected to match.
Different variables were considered such as gender, age, weight, pre-operative diagnosis, medical comorbitity, length of hospital stay, duration of the operation and anesthesia, type of prothesis, perioperative management protocol, amount of blood loss, postoperative complications, and pre- and postoperative clinical and function score.
Results
There were no significant preoperative differences between the patients having bilateral or unilateral TKAs, and, in particular, the comorbitity grade was not significantly different. Clinical and functional outcome according to the Knee Society Guidelines were similar for both groups. Average length of hospital stay and blood loss was increased in the one-stage group, but not doubled compared to the unilateral group.
Discussion
Although the one-satge bilateral procedure was associated with few early postoperative complications in our series, it is a safe and effective option in selected patients with bilateral degenerative knee problems.
