#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Bilateral versus unilateral total knee replacement – comparison of clinical and functional results in two-year follow-up


Authors: M. Rovňák 1;  M. Hrubina 1;  P. Šiarnik 2;  J. Sýkora 3;  M. Melišík 1;  L. Nečas 1
Authors place of work: Ortopedická klinika Jesseniova lekárska fakulta Univerzity Komenského a Univerzitná nemocnica Martin 1;  I. neurologická klinika lekárska fakulta Univerzity Komenského a Univerzitná nemocnica Bratislava 2;  Jesseniova lekárska fakulta Univerzity Komenského a Univerzitná nemocnica Martin 3
Published in the journal: Rozhl. Chir., 2022, roč. 101, č. 6, s. 278-283.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2022.101.6.277–282

Summary

Introduction: Total knee replacement is one of the most common surgical methods in diagnosis of end staged osteoarthritis. In this retrospective analysis, we focus on comparison of functional and clinical outcome in patients undergoing unilateral and bilateral replacement within a single surgical procedure.

Methods: 54 patients (bilateral 19, unilateral 35) underwent total knee replacement in our clinic participated in the current study. The length of hospital stay was monitored in all patients. Assessment of functional results was based on the WOMAC score, KSS 1, KSS2, range of motion and presence of complications in both groups.

Results: Both groups of patients were homogeneous with age, body mass index and sex. The length of hospital stay in the unilateral group was 4.7±1.3 and 5.6±2.0 in the bilateral group. Patients operated on unilaterally achieved flexion of 114.9±9.3 after one year, bilateral group 112.6±8.6, the difference was insignificant. In both groups, there is a significant improvement one year postoperatively at WOMAC, KSS1 and KSS2. Comparing WOMAC, KSS1 and KSS2 between the unilateral and bilateral groups 3, 6, 12 months postoperatively, the differences are insignificant. The revision of implants in two-year follow-up reached 1.5% in unilateral group and 1.4% in bilateral group.

Conclusion: Unilateral and bilateral knee joint endoprosthesis implantation is a successful surgical method in orthopedic practice. With conscious selection of patients, bilateral implantation may be more advantageous alternative, as the patient undergoes one operation and the associated risks.

Keywords:

knee joint – total arthroplasty – bilateral – unilateral – functional results


Zdroje

1. Memtsoudis SG, Ma Y, Chiu YL, et al. Bilateral total knee arthroplasty: risk factors for major morbidity and mortality. Anesth Analg. 2011;113:784–790. doi: 10.1213/ANE.0b013e3182282953

2. Robertsson O, Ranstam J. No bias of ignored bilaterality when analysing there vision risk of knee prostheses: analysis of a population based sample of 44,590 patients with 55,298 knee prostheses from the national Swedish Knee Arthroplasty Register. BMC Musculoskelet Disord. 2003;4:1. doi: 10.1186/1471-2474-4-1

3. Bellamy N. WOMAC osteoarthritis index: user guide IX. 2009, Queensland (Australia)

4. Insall JN, Dorr LD, Scott RD, et al. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res. 1989;248:13–14.

5. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthrosis. Ann Rheum Dis. 1957;16:494–502.

6. Boyerab B, Bordinia B, Caputoa D, et al. Unilateral versus bilateral total knee arthroplasty: A registry study on survival and risk factors. Orthopaedics & Traumatology: Surgery & Research 2019;105(4):627−663. doi.org/10.1016/j. otsr.2019.01.023.

7. Bohm ER, Molodianovitsh K, Dragan A, et al. Out-comes of unilateral and bilateral total knee arthroplasty in 238,373 patients. Acta Orthop. 2016;87:24–30. doi: 10.1080/17453674.2016.1181817.

8. Hooper GJ, Hooper NM, Rothwell AG, et al. Bilateral total joint arthroplasty: the early results from the New Zealand National Joint Registry. J Arthroplasty 2009; 24:1174–1177. doi: 10.1016/j. arth.2008.09.022.

9. Thès A, Molina V, Lambert T, Simultaneous bilateral total knee arthroplasty in severe hemophilia: a retrospective cost-effectiveness analysis. Orthop Traumatol Surg Res. 2015;101:147–50. doi: 10.1016/j.otsr.2014.12.010.

10. Noble J, Goodall JR, Noble DJ. Simultaneous bilateral total knee replacement: a persistent controversy. Knee. 2009;16:420–426. doi: 10.1016/j.knee. 2009.04.009.

11. Barrett J, Baron JA, Losina E, et al. Bilateral total knee replacement: staging and pulmonary embolism. J Bone Joint Surg Am. 2006;88: 2146–2151. doi: 10.2106/ JBJS.E.01323.

12. Oakes DA, Hanssen AD. Bilateral total knee replacement using the same anestheticis not justified by assessment of ther isks. Clin Orthop Relat Res. 2004;428:87–91. doi: 10.1097/01. blo.0000147133.75432.86.

13. Křivánek S, Hrubina M. Chmúrny M, et al. Bilaterálna implantácia TEP kolenného kĺbu – krátkodobé funkčné výsledky, Acta Chir Orthop Traumatol Cech. 2016;83(6):405–410.

14. Limin Liu, Hongtian Liu, Hui Zhang, et al. Bilateral total knee arthroplasty: simultaneous or staged? a systematic review and meta-analysis, Medicine (Baltimore) 2019 May;98(22):e15931. doi: 10.1097/ MD.0000000000015931.

15. Sheth S, Cafri G, Paxton EW, et al. Bilateral simultaneous vs staged total knee arthroplasty: a comparison of complications and mortality, J Arthroplasty 2016 Sep;31(9 Suppl):212−216. doi: 10.1097/ MD.0000000000015931

16. Dhiren Jenny JY, Trojani C, Prudhon JL, et al. Simultaneous bilateral total knee arthroplasty. A multicenter feasibility study. Orthop Traumatol Surg Res. 2013;99(2):191. doi: 10.1016/j. otsr.2012.12.015.

17. Hadley S, Day M, Schwarzkopf R, et al. Simultaneous bilateral total knee arthroplasty (BTKA) as safe as staged BTKA? Am J Orthop. 2017;46(4):E224−E229.

18. Makaram NS, Roberts SB, Macpherson GJ, Simultaneous bilateral total knee arthroplasty is associated with shorter length of stay but increased mortality compared with staged bilateral total knee arthroplasty: A systematic review and meta-analysis, J Arthroplasty 2021, 36(6):2227−2238. doi: 10.1016/j. arth.2021.01.045.

Štítky
Surgery Orthopaedics Trauma surgery
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#