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Related Experiment Videos

Simultaneous bilateral total knee replacement versus unilateral replacement

R L Worland1, D E Jessup, C Clelland

  • 1Advanced Orthopaedic Centers, Health South Hospital, Richmond, Virginia, USA.

American Journal of Orthopedics (Belle Mead, N.J.)
|April 1, 1996
PubMed
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Simultaneous bilateral total knee arthroplasty is safe and effective for patients with osteoarthritis. Functional outcomes and complication rates are comparable to unilateral procedures, supporting same-anesthetic bilateral surgery.

Area of Science:

  • Orthopedic Surgery
  • Arthroplasty
  • Biomedical Engineering

Background:

  • Osteoarthritis frequently affects both knees, necessitating treatment options for bilateral knee arthritis.
  • Simultaneous bilateral total knee arthroplasty (TKA) offers potential benefits like reduced overall healthcare costs and fewer anesthetic exposures.
  • However, concerns regarding increased complication rates and comparable functional outcomes have historically limited its widespread adoption.

Purpose of the Study:

  • To compare postoperative complications and functional improvements between simultaneous bilateral TKAs and unilateral TKAs.
  • To evaluate the safety and efficacy of performing bilateral total knee arthroplasties under a single anesthetic.
  • To determine if bilateral TKAs are a viable option for patients with bilateral knee osteoarthritis.

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Main Methods:

  • A retrospective review of 213 simultaneous bilateral TKAs (426 knees) and 107 matched unilateral TKAs performed over a 5-year period.
  • Patients in both groups were primarily diagnosed with osteoarthritis and had an average age of 70 years.
  • Postoperative complications and functional outcomes, assessed using Hospital for Special Surgery (HSS) scores, were compared between the two groups.

Main Results:

  • Knee function, measured by HSS scores, showed no significant difference between the bilateral (93.6) and unilateral (93.4) groups.
  • The complication rate in the simultaneous bilateral TKA group was not increased compared to the unilateral TKA group; in fact, it was lower.
  • Average patient age was 70 years, and the primary diagnosis was osteoarthritis for both cohorts.

Conclusions:

  • Simultaneous bilateral total knee arthroplasty is a safe and effective procedure for patients with bilateral knee osteoarthritis.
  • The functional outcomes and complication rates are comparable, and potentially better, than staged unilateral procedures.
  • Bilateral TKAs performed under a single anesthetic are recommended for suitable patients when surgical teams can operate expeditiously.