A Retrospective Cohort Study Comparing the Functional and General Health Outcomes of Staged vs Simultaneous Bilateral...

Bilateral primary total knee replacements (TKRs) can be performed simultaneously (under the same anaesthetic) or staged (on separate occasions). Patients who undergo simultaneous biltateral TKRs only have one anaesthetic, operation and hospital stay. This reduces overall time in pain, rehabilitation time and total days in hospital with cost-saving implications. Despite the benefits, simultaneous bilateral TKRs are not routinely performed due to fear of worse outcomes.

This paper assesses the long-term functional and general health outcomes between the two approaches.

We undertook a retrospective cohort study. Patients who underwent a bilateral TKR in our centre from 2012-2014 were included. The validated Oxford Knee and EuroQol scores were used to assess function and general health outcomes. These were assessed at baseline and 1-year along with satisfaction scores.

41 simultaneous bilateral TKRs and 43 staged bilateral TKRs met the inclusion criteria. Patients were age and sex matched. The Oxford Knee Score increase at one year was equivalent in both groups (20.1 vs. 18.1, p=0.170), suggesting no difference in long-term function. The EuroQol Score increase at one year was equivalent in both groups (0.41 vs. 0.48, p=0.350), suggesting no difference in long-term general health. Satisfaction was comparable between the two groups (88.8 vs. 86.2, p=0.52).

There is no difference in functional and general health outcomes between staged and simultaneous bilateral knee replacements. In patients with bilateral knee arthritis, simultaneous bilateral TKRs should be considered.