Functional Outcome of Bilateral Total Knee Replacement in Advanced Osteoarthritis in Simultaneous Versus Staged
I K Kundu1, A Z Chowdhury, A Faisal
1Dr Indrojit Kumar Kundu, Assistant Professor, Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;
Abstract:
Osteoarthritis (OA) is a chronic, progressive disease involving the degeneration of cartilage and joint tissue, resulting in pain and disability. Bilateral total knee arthroplasty (TKA) is is an effective intervention that improves quality of life, reduces pain and increases functional capability. This study was performed to compare the functional outcomes between staged and simultaneous total knee arthroplasty. This prospective interventional study was carried out in Arthroscopic and Arthroplasty unit of BSMMU, Dhaka from January 2017 to December 2018. A total of 60 OA patients underwent TKA were included in this study. Thirty patients underwent simultaneous TKA procedure and 30 patients underwent staged TKA procedures performed with 1-6 months between stages were included. Pre-operative and post operative data were collected. Data were analyzed using SPSS 12.0. Numerical data were analyzed using unpaired t test and categorical data were analyzed using Chi-Square test. A value of p<0.05 was considered statistically significant. Mean age of the study subjects was 60.47±10.13 years in staged group and 59.30±9.90 years in simultaneous group. Male to female ratio was 1:1.5 in staged group and 1:2 in simultaneous group. Mean BMI of the study subjects was 30.70±4.91kg/m² in staged group and 30.06±4.79kg/m² in simultaneous group (p>0.05). In both groups, maximum study subjects were housewife (33.3% vs. 33.3%). In staged group 13.3% and 16.7% in simultaneous group were heavy worker; 20.0% in staged group and 16.7% in simultaneous group were medium worker (p>0.05). Pain, motion, stability and function were significantly changed after surgery comparing before surgery.Infection was observed in 10.0% cases in both groups. Stiffness was observed in 10.0% cases in staged group but in 6.7% cases in simultaneous group. Even final outcome showed better in simultaneous procedure, there was no significant difference between two procedures. The outcome of both simultaneous andstaged procedure of bilateral total knee replacement in Advanced Osteoarthritis is similar.
