Clinical Outcome Comparison between Staged -Bilateral Versus Simultaneous Bilateral Total Knee Replacements
Mohammad Mahdi Sarzaeem1, Farzad Amoozadeh Omrani1, Mohammad Mahdi Omidian1
1Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran.
The Archives of Bone and Joint Surgery
|February 2, 2022
Summary
This study found no significant difference in clinical outcomes between simultaneous and staged bilateral total knee arthroplasty (TKA). Both procedures offer comparable improvements in knee function and patient-reported scores.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Bilateral total knee arthroplasty (TKA) involves performing the procedure on both knees.
- Controversy exists regarding the optimal timing for bilateral TKA: simultaneous versus staged procedures.
- Surgeons face challenges in deciding between simultaneous and staged bilateral TKA due to varying clinical outcome data.
Purpose of the Study:
- To compare the clinical outcomes of simultaneous bilateral total knee arthroplasty (TKA) versus staged bilateral TKA.
- To evaluate functional recovery and patient-reported outcomes between the two surgical approaches.
- To provide evidence to inform surgical decision-making for bilateral knee replacements.
Main Methods:
- Retrospective study of 100 patients undergoing bilateral TKA between 2014 and 2017.
- Patients were divided into simultaneous (n=51) and staged (n=49) bilateral TKA groups.
- Outcomes assessed included range of motion (ROM), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and SF-36 scores over a 24-month follow-up.
Main Results:
- No significant differences were observed in SF-36 scores between the simultaneous and staged TKA groups.
- Mean OKS and WOMAC improvement scores were comparable across both groups.
- Final knee ROM was acceptable and showed no statistically significant difference between simultaneous and staged bilateral TKA.
Conclusions:
- Bilateral TKA, whether performed simultaneously or staged, yields similar clinical and functional outcomes.
- Key patient-reported outcome measures (OKS, WOMAC, SF-36) and ROM show comparable improvements regardless of surgical timing.
- The study suggests that both simultaneous and staged bilateral TKA are viable options with no statistically significant difference in outcomes.
