Article
Bilateral total knee replacement is safe
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Authors
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Benjamin Bender
- Assuta Tel-Aviv Hospital, Petah Tikva, Israel
| Published: | November 6, 2018 |
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Outline
Text
Objectives: Numerous patients suffer from painful arthritis in both knees. Simultaneous TKR has been debated in many studies. Some studies raised a concern for increased rate of complications while others dispute it. The purpose of this study was to investigate the safety and outcome following bilateral TKR procedures
Methods: 52 patients included in this study underwent simultaneous patient specific bilateral TKR, 52 procedures (total joint replacements), 104. 51 patients were diagnosed with OA, and one patient with RA. The mean age was 64 (range 49-75). There were 22 male and 30 female patients. One patient was excluded from the study following a severe injury from a shell during protective-edge operation. BMI mean value was 30 (range 22-39). All patients were ASA 1-2 (low risk). The surgeries were conducted under General Anesthesia in majority of cases (68%), spinal- epidural was used in the rest. The prothesis used was Vangured (Biomet), Gemnini Link
Results: The mean length of inpatient stay was 5 (Range 3-8 days). 72% of patients were discharged to a rehabilitation center, 28 % patients went home. 72% received blood transfusion. One patient in one knee developed superficial wound infection. Mean operation time (skin cut to closure) was 79 minutes for each knee. No deep infection noted. One patient had intraoperative fracture which was fixed with a plate, at 1 year f/u the fracture was united and no subsidence of the prosthesis was noted. No neurological events recorded. None of patients spent even a single day in the ICU. All were ambulating by the 2nd post-operative day. All patients would have recommended the surgery to other. Revision d/t loosening was conducted on two knees on two different patients.
Conclusion: Bilateral TKR provides shorter recovery time, shorter absence from work, high patient satisfaction, one anesthetic administration and decreased total cost. Low risk patient selection is fundamental for the success of the surgery and complication avoidance. In this series of patients Bilateral TKR no embolic complications from cement and fat pressurization were noted.
