Clinical Analysis Of Simultaneous Bilateral Total Knee Arthroplasty

ObjectivesThe purpose of this study was to compare the differences of simultaneous bilateral total knee arthroplasty(BTKA) and staged bilateral total knee arthroplasty according to perioperative complications, curative effect, hospital stay period and hospital cost. Then discuss the advantages and disadvantages of simultaneous BTKA.MethodsBTKA were performed on 51 patients from Mar 2005 through Feb 2009 by the same team of orthopedic surgeons. Of which 26 patients (52 knees) were performed by simultaneous BTKA, while 25 cases (50 knees) were performed by two-staged BTKA. For the later group the interval between the two operations was 3-10months. The primary disorder for surgery is severe osteoarthritis of knee and the cemented, posterior stabilized prosthesises of knee joints were used for all patients. All of the 51 patients were followed up by telephone or outpatient visit 6-48 months (mean 26 months) postoperatively.ResultsThere was no statistic significance between simultaneous BTKA and staged BTKA in comparison of score of HSS (p>0.05). However the incidence rate of perioperative complications in simultaneous BTKA was higher than that in staged BTKA(p<0.01). The cardiovascular disorders, the deep venous thrombosis (DVT) and mental problems were the common complications. No joint infection and death case occurred in the two groups. The days of hospitalization and total cost were reduced by 14-22 days and 38.8% respectively in simultaneous BTKA compared with staged BTKA.ConclusionsSimultaneous BTKA is safe and effective for the treatment of severe osteoarthritis of knee joint. The hospital cost and stay are significantly decreased. Functional rehabilitation in bilateral extremities can be performed simultaneously and therefore increase the efficiency of surgery. However, The operation injury to the patient is more serious, bleeding more, the anesthetic time is longer and the periopertive complications are more common in simultaneous BTKA. So the general condition of the patients must be evaluated seriously before operation, and we do not recommend simultaneous BTKA for the old patient whose health condition is very poor.