Functional outcome of staged bilateral knee replacements

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Staged bilateral total knee arthroplasty (TKA) is a common procedure for patients with severe knee osteoarthritis affecting both limbs.
• Understanding the comparative functional outcomes between the first and second TKA is crucial for optimizing patient care and surgical planning.

Purpose of the Study:

• To compare the functional outcomes between the first and second knee replacement in patients undergoing staged bilateral total knee arthroplasty.
• To evaluate differences in pain, mobility, joint function, and overall well-being after sequential TKAs.

Main Methods:

• A retrospective study of 64 patients who underwent staged bilateral TKAs with at least one year of follow-up.
• Collected data included pain scores, walking ability, walking aid use, range of motion, instability, muscle strength, WOMAC scores, SF-12 scores, and hospital length of stay (LOS).
• Statistical analysis was performed to compare outcomes between the first and second knee replacement procedures.

Main Results:

• Four outcomes demonstrated statistically significant differences between the first and second knee replacements.
• Improved postoperative walking ability (4.83 vs 4.51, p=0.03) and reduced walking aid requirement (5.73 vs 5.46, p=0.01) were observed after the second TKA.
• Patients reported better postoperative SF-12 scores (54.26 vs 52.45, p=0.04) and a shorter length of hospital stay (4.73 days vs 6.16 days, p=0.05) following the second procedure.

Conclusions:

• Patients undergoing staged bilateral total knee arthroplasty experience significant improvements after the second procedure.
• These improvements include enhanced walking ability, decreased reliance on walking aids, better psychological well-being, and a reduced length of hospital stay.
• The findings suggest continued functional recovery and patient benefit beyond the initial knee replacement.