No difference in the functional improvements between unilateral and bilateral total knee replacements

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Few studies compare functional outcomes between staged and simultaneous bilateral total knee replacement (TKR).
• Understanding functional improvements from different TKR approaches is crucial for patient care.

Purpose of the Study:

• To investigate and compare functional improvements following staged bilateral total knee replacement versus simultaneous bilateral total knee replacement.
• To assess patient-reported outcomes using validated instruments.

Main Methods:

• 144 patients undergoing TKR were analyzed, with 93 choosing unilateral and 51 opting for bilateral procedures.
• Functional outcomes were measured using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Short Form-36 (SF-36) pre-operatively and at 6 months post-surgery.
• A generalized estimating equation was employed to determine differences in functional improvements.

Main Results:

• Both unilateral and bilateral TKR significantly reduced pain, stiffness, and improved function, as indicated by WOMAC scores.
• SF-36 scores showed comparable improvements in physical and mental components between the groups.
• No significant differences in functional improvements were observed between unilateral and bilateral TKR approaches.

Conclusions:

• Unilateral and simultaneous bilateral total knee replacement yield similar functional improvements.
• Current work status may represent a novel factor influencing outcomes.
• No definitive recommendation can be made for one TKR procedure over the other based on functional outcomes.