Clinical Outcome Comparison between Staged –Bilateral Versus Simultaneous Bilateral 1 Total Knee Replacements

Document Type : RESEARCH PAPER

Authors

1 Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran

2 Department of Biomaterials, Faculty of Biomedical Engineering, Science and Research, Branch, Islamic Azad University, Tehran, Iran

3 Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran

Abstract

Background: This retrospective study aimed to compare the clinical outcomes of patients with staged and simultaneous bilateral total knee arthroplasty (TKA). Methods: The present study included 100 patients with a mean age of 62±3.72 years from 2014 to 2017. Among them, 51 and 49 patients underwent simultaneous and staged bilateral TKA, respectively. The two groups were compared regarding the range of motion (ROM), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) improvement, and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) scores. The mean follow-up duration was 24 months (range: 12-36 months). Results: According to the results obtained from the SF-36 questionnaire (possessing eight different factors of quality of life), there was no significant difference between the two groups. Furthermore, the OKSs were 39.98±1.52 and 38.68±2.55 in the simultaneous and staged groups, respectively. Moreover, the WOMAC improvement scores were obtained at 84.15±2.2 and 83.26±2.6 in the simultaneous and staged groups, respectively. The final knee ROM was acceptable without a significant difference between the two groups Conclusion: Substantial controversy about the complications, functional, and clinical outcomes has negatively affected the decision of the surgeons on conducting bilateral sequential TKA. This clinical assessment revealed that all determinants, including OKS, WOMAC, SF-36, ROM, postoperative bleeding, and hospitalization duration exhibited almost the same improvement in both groups. According to this study, no statistically significant difference exists in both procedures. Level of evidence: III

Keywords

References

1. Sun BH, Wu CW, Kalunian KC. New developments in osteoarthritis. Rheum Dis Clin North Am. 2007;33(1):135-48.
2. Lonner JH, Jasko JG, Bezwada HP, Booth RE, Jr. Morbidity of sequential bilateral revision TKA performed under a single anesthetic. Clin Orthop Relat Res. 2007;464:151-6.
3. Ko Y, Narayanasamy S, Wee HL, Lo NN, Yeo SJ, Yang KY, et al. Health-related quality of life after total knee replacement or unicompartmental knee arthroplasty in an urban asian population. Value Health. 2011;14(2):322-8.
4. Carr AJ, Robertsson O, Graves S, Price AJ, Arden NK, Judge A, et al. Knee replacement. Lancet. 2012;379(9823):1331-40.
5. Memtsoudis SG, Ma Y, Chiu Y-L, Poultsides L, Gonzalez Della Valle A, Mazumdar M. Bilateral total knee arthroplasty: risk factors for major morbidity and mortality. Anesth Analg. 2011;113(4):784-90.
6. Sheth DS, Cafri G, Paxton EW, Namba RS. Bilateral Simultaneous vs Staged Total Knee Arthroplasty: A Comparison of Complications and Mortality. J Arthroplasty. 2016;31(9 Suppl):212-6.
7. Sobh AH, Siljander MP, Mells AJ, Koueiter DM, Moore DD, Karadsheh MS. Cost Analysis, Complications, and Discharge Disposition Associated With Simultaneous vs Staged Bilateral Total Knee Arthroplasty. J Arthroplasty. 2018;33(2):320-3.
8. Memtsoudis SG, Mantilla CB, Parvizi J, Stundner O, Mazumdar M. Have bilateral total knee arthroplasties become safer? A population-based trend analysis. Clin Orthop Relat Res. 2013;471(1):17-25.
9. Phillips JLH, Rondon AJ, Gorica Z, Fillingham YA, Austin MS, Courtney PM. No Difference in Total Episode-of-Care Cost Between Staged and Simultaneous Bilateral Total Joint Arthroplasty. J Arthroplasty. 2018;33(12):3607-11.
10. Seo JG, Lee BH, Moon YW, Chang MJ, Park SH. Disparate postoperative results in the first and second knees on simultaneous bilateral total knee arthroplasty. J Arthroplasty. 2014;29(12):2331-6.
11. Malahias MA, Gu A, Adriani M, Addona JL, Alexiades MM, Sculco PK. Comparing the Safety and Outcome of Simultaneous and Staged Bilateral Total Knee Arthroplasty in Contemporary Practice: A Systematic Review of the Literature. J Arthroplasty. 2019;34(7):1531-7.
12. Fu D, Li G, Chen K, Zeng H, Zhang X, Cai Z. Comparison of clinical outcome between simultaneous-bilateral and staged-bilateral total knee arthroplasty: a systematic review of retrospective studies. J Arthroplasty. 2013;28(7):1141-7.
13. Lindberg-Larsen M, Jørgensen CC, Husted H, Kehlet H. Early morbidity after simultaneous and staged bilateral total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2015;23(3):831-7.
14. Bini SA, Khatod M, Inacio MC, Paxton EW. Same-day versus staged bilateral total knee arthroplasty poses no increase in complications in 6672 primary procedures. J Arthroplasty. 2014;29(4):694-7.
15. Ebrahimzadeh MH, Makhmalbaf H, Birjandinejad A, Soltani-Moghaddas SH. Cross-cultural adaptation and validation of the persian version of the oxford knee score in patients with knee osteoarthritis. Iran J Med Sci. 2014;39(6):529-35.
16. Ebrahimzadeh MH, Makhmalbaf H, Birjandinejad A, Keshtan FG, Hoseini HA, Mazloumi SM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Persian Speaking Patients with Knee Osteoarthritis. Arch Bone Jt Surg. 2014;2(1):57-62.
17. Picavet HS, Hazes JM. Prevalence of self-reported musculoskeletal diseases is high. Ann Rheum Dis. 2003;62(7):644-50.
18. Walmsley P, Murray A, Brenkel IJ. The practice of bilateral, simultaneous total knee replacement in Scotland over the last decade. Data from the Scottish Arthroplasty Project. Knee. 2006;13(2):102-5.
19. Liu L, Liu H, Zhang H, Song J, Zhang L. Bilateral total knee arthroplasty: Simultaneous or staged? A systematic review and meta-analysis. Medicine (Baltimore). 2019;98(22):e15931.
20. Courtney PM, Melnic CM, Alosh H, Shah RP, Nelson CL, Israelite CL. Is bilateral total knee arthroplasty staged at a one-week interval safe? A matched case control study. J Arthroplasty. 2014;29(10):1946-9.
21. Hadley S, Day M, Schwarzkopf R, Smith A, Slover J, Zuckerman J. Is Simultaneous Bilateral Total Knee Arthroplasty (BTKA) as Safe as Staged BTKA? Am J Orthop (Belle Mead NJ). 2017;46(4):E224-e9.
22. Bohm ER, Molodianovitsh K, Dragan A, Zhu N, Webster G, Masri B, et al. Outcomes of unilateral and bilateral total knee arthroplasty in 238,373 patients. Acta Orthop. 2016;87 Suppl 1(Suppl 1):24-30.
23. Sarzaeem MM, Amozade Omrani F, Rostami Abousaidi S, Aghaalikhani M. Incidence of Deep Vein Thrombosis Following Staged Bilateral and Simultaneous Bilateral Total Knee Arthroplasty. Trauma Monthly. 2017;22(4).
24. Ries MD, Rauscher LA, Hoskins S, Lott D, Richman JA, Lynch F, Jr. Intramedullary pressure and pulmonary function during total knee arthroplasty. Clin Orthop Relat Res. 1998(356):154-60.
25. Lane GJ, Hozack WJ, Shah S, Rothman RH, Booth RE, Jr., Eng K, et al. Simultaneous bilateral versus unilateral total knee arthroplasty. Outcomes analysis. Clin Orthop Relat Res. 1997(345):106-12.
26. Keurentjes JC, Van Tol FR, Fiocco M, So-Osman C, Onstenk R, Koopman-Van Gemert AW, et al. Patient acceptable symptom states after totalhip or knee replacement at mid-term follow-up: Thresholds of the Oxford hip and knee scores. Bone Joint Res. 2014;3(1):7-13.
27. Kiran A, Hunter DJ, Judge A, Field RE, Javaid MK, Cooper C, et al. A novel methodological approach for measuring symptomatic change following total joint arthroplasty. J Arthroplasty. 2014;29(11):2140-5.
28. Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br. 1998;80(1):63-9.
29. Judge A, Arden NK, Kiran A, Price A, Javaid MK, Beard D, et al. Interpretation of patient-reported outcomes for hip and knee replacement surgery: identification of thresholds associated with satisfaction with surgery. J Bone Joint Surg Br. 2012;94(3):412-8.
30. Petersen CL, Kjærsgaard JB, Kjærgaard N, Jensen MU, Laursen MB. Thresholds for Oxford Knee Score after total knee replacement surgery: a novel approach to post-operative evaluation. J Orthop Surg Res. 2017;12(1):89.
31. Bellamy N, Kirwan J, Boers M, Brooks P, Strand V, Tugwell P, et al. Recommendations for a core set of outcome measures for future phase III clinical trials in knee, hip, and hand osteoarthritis. Consensus development at OMERACT III. J Rheumatol. 1997;24(4):799-802.
32. Brazier JE, Harper R, Munro J, Walters SJ, Snaith ML. Generic and condition-specific outcome measures for people with osteoarthritis of the knee. Rheumatology (Oxford). 1999;38(9):870-7.
33. Hooper GJ, Hooper NM, Rothwell AG, Hobbs T. Bilateral total joint arthroplasty: the early results from the New Zealand National Joint Registry. J Arthroplasty. 2009;24(8):1174-7.
34. Abram SG, Nicol F, Spencer SJ. Patient reported outcomes in three hundred and twenty eight bilateral total knee replacement cases (simultaneous versus staged arthroplasty) using the Oxford Knee Score. Int Orthop. 2016;40(10):2055-9.
35. Lee WC, Kwan YH, Yeo SJ. Severe Bilateral Fixed Flexion Deformity-Simultaneous or Staged Total Knee Arthroplasty? The Journal of arthroplasty. 2016;31(1):128-31.
36. Seol JH, Seon JK, Song EK. Comparison of postoperative complications and clinical outcomes between simultaneous and staged bilateral total knee arthroplasty. J Orthop Sci. 2016;21(6):766-9.
37. Bulbul M, Ayanoğlu S, Imren Y, Dedeoğlu S, Esenyel C, H G. Assessment of functional outcomes of either simultaneous or staged bilateral total knee arthroplasty at year one. Nobel medicus. 2011;2011:26-9.
38. Beard DJ, Harris K, Dawson J, Doll H, Murray DW, Carr AJ, et al. Meaningful changes for the Oxford hip and knee scores after joint replacement surgery. J Clin Epidemiol. 2015;68(1):73-9.
39. Copay AG, Subach BR, Glassman SD, Polly DW, Jr., Schuler TC. Understanding the minimum clinically important difference: a review of concepts and methods. Spine J. 2007;7(5):541-6.
The Archives of Bone and Joint Surgery
Volume 9, Issue 6
November 2021
Pages 641-646

Files

History

  • Receive Date: 28 April 2020
  • Revise Date: 06 February 2021
  • Accept Date: 08 April 2021

Share

How to cite

Statistics