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Related Experiment Videos

Bilateral knee replacements: simultaneous or staged?

J P Ivory1, A H Simpson, G J Toogood

  • 1Nuffield Orthopaedic Centre, Headington, Oxford, UK.

Journal of the Royal College of Surgeons of Edinburgh
|April 1, 1993
PubMed
Summary
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Performing bilateral total knee replacements under one anesthetic is safe and effective, reducing hospital stays by 7 days per knee. However, surgeon adoption remains low, with only 24% regularly performing the procedure.

Area of Science:

  • Orthopedic Surgery
  • Anesthesiology
  • Health Economics

Background:

  • One-third of primary knee replacements address bilateral osteoarthritis.
  • Current practice often involves staged or unilateral procedures.

Purpose of the Study:

  • To compare complication rates, functional outcomes, and costs of single-anesthetic bilateral total knee replacement (BKR) versus staged BKRs and unilateral total knee replacements (TKR).

Main Methods:

  • Retrospective study comparing outcomes and costs.
  • Included patients undergoing unilateral TKR, staged BKRs, and single-anesthetic BKRs.
  • Surgical complication rates, functional outcomes, and hospital admission times were analyzed.

Main Results:

  • No significant differences in complication rates or functional outcomes were observed between the groups.

Related Experiment Videos

  • Single-anesthetic BKRs demonstrated a significant reduction in mean hospital admission time (7 days per knee replacement).
  • A survey indicated only 24% of UK knee surgeons regularly perform single-anesthetic BKRs.

    • Conclusions:

    • Single-anesthetic bilateral total knee replacement is a safe and cost-effective procedure with comparable outcomes to staged or unilateral procedures.
    • The procedure offers significant benefits in reducing hospital admission time.
    • Barriers to adoption among surgeons need to be addressed to increase utilization.