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Bilateral total knee arthroplasty guidelines: are we there yet?
Ettore Vulcano1, Stavros Memtsoudis, Alejandro Gonzalez Della Valle
1Department of Orthopaedic Surgery, Universita' dell'Insubria, Varese, VA 21100, Italy. ettorevulcano@hotmail.com
The Journal of Knee Surgery
|January 4, 2013
Summary
Bilateral total knee replacement (BTKR) use is rising, particularly in women. This review examines single-stage BTKR, highlighting its benefits and controversies compared to staged procedures or unilateral total knee replacement.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- The utilization of bilateral total knee replacements (BTKR) relative to unilateral total knee replacements (UTKR) has significantly increased in the United States.
- BTKR use more than doubled in the general population and nearly tripled in females between 1990 and 2004.
Purpose of the Study:
- To review current concepts and controversies surrounding single-stage bilateral total knee replacement (BTKR) surgery.
- To present institutional guidelines for patient selection for single-stage BTKR.
Main Methods:
- Literature review of BTKR studies.
- Analysis of institutional research and clinical experience.
Main Results:
- Single-stage BTKR offers potential advantages including reduced anesthesia exposure, shorter hospitalization and recovery, and cost-effectiveness.
- Concerns exist regarding potential increases in morbidity and mortality with single-stage BTKR compared to staged procedures.
Conclusions:
- Single-stage BTKR aims to improve patient outcomes and reduce costs while maintaining safety.
- Careful patient selection is crucial for successful single-stage BTKR outcomes.
