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Simultaneous single-stage versus two-staged bilateral total knee arthroplasty: a prospective comparative study

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Abstract

Purpose

The study aims to prospectively compare peri-operative morbidity and mortality of simultaneous single-stage bilateral total knee arthroplasty (SS BLTKA) with two-staged bilateral total knee arthroplasty (TS BLTKA) performed within 12 months of the first surgery. We hypothesized that SS BLTKA is as safe as TS BLTKA.

Methods

Patients with a minimum follow-up of 12 months were included in this study. Oxford knee score and quality of life index SF12 was compared between the 2 groups at six weeks and six month follow-up.

Results

SS BLTKA included 250 patients and TS BLTKA included 210 patients. The minimum time interval between two operations was three weeks (mean 1.6 months, range 3 weeks-12 months). There was no significant difference between the 2 groups in peri-operative mortality, surgical site infection, major peri-operative complications. There was no difference between the 2 groups in the Oxford knee score and quality of life index SF12 at 6-month follow-up. There was no difference in the range of knee flexion between the 2 groups at six months. Post-operative haemoglobin drop was significantly more in SS BLTKA patients and consequently, blood transfusion requirement was significantly higher in SS BLTKA. There was a significantly higher length of hospital stay and duration of surgery in TS BLTKA group.

Conclusion

There does not appear to be a difference in complication rates between the 2 groups. SS BLTKA seems to be a logical choice if both knees have severe osteoarthritis. Patients with severe cardiopulmonary compromise were excluded, and a unilateral procedure may be preferred in them.

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Authors and Affiliations

  1. Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India

    Tarun Goyal

  2. Department of Trauma Surgery, All India Institute of Medical Sciences, Rishikesh, India

    Md. Quamar Azam

  3. Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India

    Anjum Syed

  4. Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, India

    Souvik Paul

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  1. Tarun Goyal
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  2. Md. Quamar Azam
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Correspondence to Tarun Goyal.

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The authors declare that they have no conflicts of interest.

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The study was approved by institutional review board.

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Informed consent was obtained from all individual participants included in the study.

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Goyal, T., Azam, M.Q., Syed, A. et al. Simultaneous single-stage versus two-staged bilateral total knee arthroplasty: a prospective comparative study. International Orthopaedics (SICOT) 44, 1305–1310 (2020). https://doi.org/10.1007/s00264-020-04642-6

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  • DOI: https://doi.org/10.1007/s00264-020-04642-6

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