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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 1, 64-68.
doi: 10.1302/0301-620X.91B1.21320  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Simultaneous bilateral sequential total knee replacement is as safe as unilateral total knee replacement

Y.-H. Kim, MD, Professor and Director1; Y.-W. Choi, MD, Clinical Fellow1; and J.-S. Kim, MD, Professor1

1 The Joint Replacement Center of Korea, Ewha Womans University, School of Medicine, 911-1, MokDong, YangCheon-ku, Seoul (158-710), Korea.

Correspondence should be sent to Professor Y.-H. Kim; e-mail: younghookim{at}ewha.ac.kr

We wished to determine whether simultaneous bilateral sequential total knee replacement (TKR) carried increased rates of mortality and complications compared with unilateral TKR in low- and high-risk patients.

Our study included 2385 patients who had undergone bilateral sequential TKR under one anaesthetic and 719 who had unilateral TKR. There were no significant pre-operative differences between the groups in terms of age, gender, height, weight, body mass index, diagnosis, comorbidity and duration of follow-up, which was a mean of 10.2 years (5 to 14) in the bilateral and 10.4 years (5 to 14) in the unilateral group.

The peri-operative mortality rate (eight patients, 0.3%) of patients who had bilateral sequential TKR was similar to that (five patients, 0.7%) of those undergoing unilateral TKR. In bilateral cases the peri-operative mortality rate (three patients, 0.4%) of patients at high risk was similar to that (five patients, 0.3%) of patients at low risk as it was also in unilateral cases (two patients, 1.0% vs three patients, 0.6%). There was no significant difference (p = 0.735) in either the overall number of major complications between bilateral and unilateral cases or between low- (p = 0.57) and high-risk (p = 0.61) patients. Also, the overall number of minor complications was not significantly different between the bilateral and unilateral group (p = 0.143).

Simultaneous bilateral sequential TKR can be offered to patients at low and high risk and has an expected rate of complications similar to that of unilateral TKR.




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W. C. W. Chan, P. Musonda, A. S. Cooper, M. M. S. Glasgow, S. T. Donell, and N. P. Walton
One-stage versus two-stage bilateral unicompartmental knee replacement: A COMPARISON OF IMMEDIATE POST-OPERATIVE COMPLICATIONS
J Bone Joint Surg Br, October 1, 2009; 91-B(10): 1305 - 1309.
[Abstract] [Full Text] [PDF]


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