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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 1, 40-43.
doi: 10.1302/0301-620X.88B1.16454  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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A comparison of bilateral uncemented total knee arthroplasty

SIMULTANEOUS OR STAGED?

J. R. M. Hutchinson, FRCS (Trauma & Orth), Research Fellow1; E. N. Parish, MHSc, Research Assistant1; and M. J. Cross, OAM, MD, FRACS, Consultant Orthopaedic Surgeon1

1 Australian Institute of Musculoskeletal Research, 286 Pacific Highway, Crows Nest, Sydney, Australia 2065.

Correspondence should be sent to Dr M. J. Cross at 286 Pacific Highway, Crows Nest, 2065 Australia; e-mail: mervcros{at}ozemail.com

In a series of 1304 patients (1867 knees), the results of simultaneous and staged bilateral total knee arthroplasty were compared with each other and with unilateral total knee arthroplasty. The bilateral procedures had a significantly higher rate of complications than unilateral procedures, almost entirely because of thromboembolic problems. However, this did not correspond to an increase in mortality. If a bilateral procedure was indicated, then a simultaneous procedure had no increased risk over a staged procedure. There was no increase in cardiovascular complications, the rate of deep-vein thrombosis or pulmonary embolism or mortality. The rate of infection was lower with a bilateral procedure and the overall revision rate was less than 1% in all groups. The prosthesis functioned as well in all groups in the medium and longer term periods.

We feel that simultaneous bilateral total knee arthroplasty is a safe and successful procedure when compared with a staged bilateral procedure. It also has the added benefit of single anaesthetic, reduced costs and decreased total recovery time when compared to a staged bilateral procedure. For these reasons it should be considered as an option in the presence of bilateral knee joint disease.




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J Bone Joint Surg BrHome page
M. C. Forster, A. J. Bauze, A. G. Bailie, M. S. Falworth, and R. D. Oakeshott
A retrospective comparative study of bilateral total knee replacement staged at a one-week interval
J Bone Joint Surg Br, August 1, 2006; 88-B(8): 1006 - 1010.
[Abstract] [Full Text] [PDF]

eLetters:

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A comparison of bilateral uncemented total knee arthroplasty: SIMULTANEOUS OR STAGED?
M J Ashworth
J Bone Joint Surg Br Online, 8 Feb 2006 [Full text]
Bilateral total knee arthroplasty: SIMULTANEOUS OR SEQUENTIAL ?
Simon W Sturdee, et al.
J Bone Joint Surg Br Online, 13 Mar 2006 [Full text]
A comparison of bilateral uncemented total knee arthroplasty: SIMULTANEOUS OR STAGED?
Riaz JK Khan
J Bone Joint Surg Br Online, 4 Apr 2006 [Full text]


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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General