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Related Experiment Videos

Debate: simultaneous bilateral knee replacements: the outcomes justify its use.

Merrill A Ritter1, Leesa D Harty

  • 1Center for Hip and Knee Surgery, St. Francis Hospital, Mooresville, Mooresville, IN, USA. marittermd@yahoo.com

Clinical Orthopaedics and Related Research
|November 10, 2004
PubMed
Summary

Simultaneous bilateral total knee replacement shows good long-term survival and outcomes comparable to unilateral procedures. However, older patients undergoing this procedure face increased early mortality risks.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Clinical Outcomes Research

Background:

  • Simultaneous bilateral total knee arthroplasty (TKA) offers potential benefits like reduced overall hospital time.
  • Assessing the risks and benefits of bilateral TKA compared to unilateral TKA is crucial for patient selection and surgical planning.

Purpose of the Study:

  • To evaluate the morbidity, mortality, and clinical outcomes of simultaneous bilateral total knee arthroplasty.
  • To compare the long-term prosthesis survival and patient survival rates with unilateral TKA.

Main Methods:

  • Retrospective review of 4100 simultaneous bilateral total knee replacements.
  • Kaplan-Meier survival analyses for prosthesis revision (aseptic loosening) and patient death.
  • Assessment of complication rates and Knee Society scores.

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Main Results:

  • Average Knee Society scores were 90 at 3 years and 87 at 10 years postoperatively.
  • 10-year prosthesis survival was 98.3%; 10-year patient survival was 78.6%.
  • Early postoperative mortality (within 1 year) was 1.2%, with higher age and male gender as risk factors.

Conclusions:

  • Simultaneous bilateral TKA demonstrates comparable complication rates and clinical outcomes to unilateral TKA.
  • While long-term prosthesis survival is high, simultaneous bilateral TKA may present a greater early mortality risk, particularly in older patients.