2023, Vol. 27 ›› Issue (4): 565-571

Comparison of early efficacy and safety of simultaneous and staged bilateral total knee arthroplasty

Gu Mingxi, Wang Bo, Tian Fengde, An Ning, Hao Ruihu, Wang Changcheng, Guo Lin   

Abstract: BACKGROUND: The choice between simultaneous and staged bilateral total knee arthroplasty remains a matter of debate in orthopaedic practice when primary knee osteoarthritis patients require surgical treatment of both knees.
OBJECTIVE: To evaluate the safety and efficacy of two different surgical options for bilateral knees by comparing the differences in perioperative outcomes and early functional improvement between simultaneous bilateral total knee arthroplasty and staged bilateral total knee arthroplasty, with the aim of providing a reference for clinical decision making.
METHODS: Data of patients who received bilateral total knee arthroplasty for knee osteoarthritis at the Department of Orthopedics, Zhongshan Hospital of Dalian University from January 2016 to January 2021 were retrospectively analyzed. The patients were divided into simultaneous (n=82) and staged (n=75) groups. The preoperative general information, length of hospital stay, hospital costs, length of surgery, blood transfusion, pain visual analogue scale score, perioperative hemoglobin changes, incidence of hypoalbuminemia and perioperative complication rates, and recovery of joint function 1 year after surgery were compared between the two groups.
RESULTS AND CONCLUSION: (1) Compared with the staged group, the simultaneous group had shorter operative time and length of stay, lower hospital costs, higher incidence of anemia and hypoproteinemia, and more obvious pain. (2) The simultaneous group had higher psychological quality of life scores and forgetfulness index at the one-year postoperative follow-up. However, there were no significant differences in postoperative knee motion range, HSS scores, WOMAC index, and Feller patella scores between the two groups. (3) It is concluded that simultaneous bilateral total knee arthroplasty can limit surgery and anesthesia to a single event, promote symmetrical rehabilitation of both knees and reduce hospital stay, reduce costs for patients and hospitals, improve knee function and feel better, which is a safe and effective method for the treatment of knee arthritis.
Key words: bilateral, knee, arthroplasty, total knee arthroplasty, osteoarthritis, simultaneous, staging, replacement