• Vol. 44 No. 11, 514–518
  • 15 November 2015

Functional Outcomes of the Second Surgery Are Similar to the First in Asians Undergoing Staged-Bilateral Total Knee Arthroplasty



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Introduction: Patients suffering from bilateral knee osteoarthritis often require bilateral total knee arthroplasty (TKA) to alleviate symptoms. There is controversy surrounding the approach to the surgical treatment of such patients. We asked if Asian patients undergoing staged-bilateral TKA had any difference in their short-term functional outcomes, comparing the first TKA to the second one and if the interval between the 2 surgeries had any impact of functional outcomes.

Materials and Methods: We identified 100 patients from a single surgeon from 2006 to 2010 who had staged-bilateral TKA and had at least 2 years of follow-up for each TKA. The time interval between the first and second TKA ranged from 6 months to 1 year. Range of motion, Oxford knee questionnaire scores, knee scores and function scores at 6 months and 2 years of follow-up were then compared between the first and second TKA using the Student’s T-test

Results: Although length of stay was reduced and time to ambulation was shorter for the second TKA, there were no significant differences in functional outcomes at 2 years. There was also no difference in outcome when patients were stratified according to time interval between TKAs.

Conclusion: Staged-bilateral TKA continues to be a good option for patients presenting with severe bilateral knee osteoarthritis. The second arthroplasty has similar functional outcomes as the first arthroplasty. Our results can be used in preoperative counselling of patients undergoing staged-bilateral TKA.

Total knee arthroplasty (TKA) is one of the most common elective surgical procedures performed to alleviate pain and disability associated with knee osteoarthritis. Patients suffering from bilateral knee osteoarthritis intuitively would require bilateral TKA. In such patients, the surgeries can be performed either simultaneously or in a staged manner. A simultaneous-bilateral TKA offers an advantage of a single hospital stay and shorter rehabilitation period thereby making it more cost effective. However, there are concerns with the safety of simultaneous-bilateral TKA. A higher risk of serious cardiac complications, pulmonary complications, and mortality was reported with simultaneous-bilateral knee arthroplasty as compared with staged-bilateral or unilateral TKA.

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