Journal List > J Korean Orthop Assoc > v.50(1) > 1013355

Park and Yim: Complication Rate and Clinical Result of One-Week Interval Staged Bilateral Total Knee Arthroplasty: Compared to Simultaneous and Several-Months Interval Staged Bilateral Total Knee Arthroplasty

Abstract

Purpose

The purpose of this study is to compare the clinical results and the rates of complication among three groups that received the simultaneous total knee replacement (TKR), one-week interval staged bilateral TKR, or several-months interval staged TKR.

Materials and Methods

We conducted a retrospective study of patients who had been diagnosed with bilateral degenerative osteoarthritis undergoing bilateral TKR from 2004 May to 2012 March. We divided patients into three groups which received simultaneous TKR (Group A, n=84), one-week interval staged bilateral TKR (Group B, n=124), or several-months interval staged TKR (Group C, n=65). Hospital for special surgery (HSS) score and the rate of complication were evaluated and compared.

Results

Mean postoperative HSS score showed significant improvement in the three groups. No difference in postoperative HSS was observed among the three groups (p=0.325). The complication rate in Group A was lower than that in Group B (p=0.049) and that in Group A was similar to that in Group C (p=0.786).

Conclusion

Group A had a better result than Group B and was similar to Group C in complication rate. One-week interval staged TKR can be good choice in patients with bilateral degenerative osteoarthritis.

Figures and Tables

Table 1

Demographics

jkoa-50-1-i001

Values are presented as mean±standard deviation, number only, or number (%). Group A: the one-week interval staged total knee replacement (TKR), Group B: the simultaneous TKR, Group C: the several-months interval staged TKR.

Table 2

Comparison of Clinical Results

jkoa-50-1-i002

Values are presented as mean±standard deviation. HSS, hospital for special surgery scoring system. Group A: the one-week interval staged total knee replacement (TKR), Group B: the simultaneous TKR, Group C: the several-months interval staged TKR.

Table 3

Comparison of Complications

jkoa-50-1-i003

Values are presented as number (%). Group A: the one-week interval staged total knee replacement (TKR), Group B: the simultaneous TKR, Group C: the several-months interval staged TKR.

Table 4

Comparison of Complications between Group A and B/Group B and C

jkoa-50-1-i004

Values are presented as number (%). Group A: the one-week interval staged total knee replacement (TKR), Group B: the simultaneous TKR, Group C: the several-months interval staged TKR.

Table 5

Comparison of Complications Based on Grade

jkoa-50-1-i005

Values are presented as number (%). Group A: the one-week interval staged total knee replacement (TKR), Group B: the simultaneous TKR, Group C: the several-months interval staged TKR.

Notes

The authors have nothing to disclose.

References

1. Leonard L, Williamson DM, Ivory JP, Jennison C. An evaluation of the safety and efficacy of simultaneous bilateral total knee arthroplasty. J Arthroplasty. 2003; 18:972–978.
2. Macario A, Schilling P, Rubio R, Goodman S. Economics of one-stage versus two-stage bilateral total knee arthroplasties. Clin Orthop Relat Res. 2003; 414:149–156.
3. Reuben JD, Meyers SJ, Cox DD, Elliott M, Watson M, Shim SD. Cost comparison between bilateral simultaneous, staged, and unilateral total joint arthroplasty. J Arthroplasty. 1998; 13:172–179.
4. Odum SM, Troyer JL, Kelly MP, Dedini RD, Bozic KJ. A cost-utility analysis comparing the cost-effectiveness of simultaneous and staged bilateral total knee arthroplasty. J Bone Joint Surg Am. 2013; 95:1441–1449.
5. Lindberg-Larsen M, Jørgensen CC, Husted H, Kehlet H. Early morbidity after simultaneous and staged bilateral total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014; [Epub ahead of print].
6. Niki Y, Katsuyama E, Takeda Y, Enomoto H, Toyama Y, Suda Y. Comparison of postoperative morbidity between simultaneous bilateral and staged bilateral total knee arthroplasties: serological perspective and clinical consequences. J Arthroplasty. 2014; 29:504–509.
7. Brotherton SL, Roberson JR, de Andrade JR, Fleming LL. Staged versus simultaneous bilateral total knee replacement. J Arthroplasty. 1986; 1:221–228.
8. Lane GJ, Hozack WJ, Shah S, et al. Simultaneous bilateral versus unilateral total knee arthroplasty. Outcomes analysis. Clin Orthop Relat Res. 1997; 345:106–112.
9. Lynch NM, Trousdale RT, Ilstrup DM. Complications after concomitant bilateral total knee arthroplasty in elderly patients. Mayo Clin Proc. 1997; 72:799–805.
10. Sliva CD, Callaghan JJ, Goetz DD, Taylor SG. Staggered bilateral total knee arthroplasty performed four to seven days apart during a single hospitalization. J Bone Joint Surg Am. 2005; 87:508–513.
11. Stanley D, Stockley I, Getty CJ. Simultaneous or staged bilateral total knee replacements in rheumatoid arthritis. A prospective study. J Bone Joint Surg Br. 1990; 72:772–774.
12. Forster MC, Bauze AJ, Bailie AG, Falworth MS, Oakeshott RD. A retrospective comparative study of bilateral total knee replacement staged at a one-week interval. J Bone Joint Surg Br. 2006; 88:1006–1010.
13. Alosh H, Shah RP, Courtney PM, Virk S, Israelite CL. One-week staged bilateral total knee arthroplasty protocol: a safety comparison of intended and completed surgeries. J Arthroplasty. 2014; 29:1176–1180.
14. Marshall JL, Fetto JF, Botero PM. Knee ligament injuries: a standardized evaluation method. Clin Orthop Relat Res. 1977; 123:115–129.
15. Iorio R, Della Valle CJ, Healy WL, et al. Stratification of standardized TKA complications and adverse events: a brief communication. Clin Orthop Relat Res. 2014; 472:194–205.
16. Healy WL, Della Valle CJ, Iorio R, et al. Complications of total knee arthroplasty: standardized list and definitions of the Knee Society. Clin Orthop Relat Res. 2013; 471:215–220.
17. Sink EL, Leunig M, Zaltz I, Gilbert JC, Clohisy J. Academic Network for Conservational Hip Outcomes Research Group. Reliability of a complication classification system for orthopaedic surgery. Clin Orthop Relat Res. 2012; 470:2220–2226.
18. Oakes DA, Hanssen AD. Bilateral total knee replacement using the same anesthetic is not justified by assessment of the risks. Clin Orthop Relat Res. 2004; 428:87–91.
19. Odum SM, Springer BD. In-hospital complication rates and associated factors after simultaneous bilateral versus unilateral total knee arthroplasty. J Bone Joint Surg Am. 2014; 96:1058–1065.
20. Dindo D, Clavien PA. What is a surgical complication? World J Surg. 2008; 32:939–941.
21. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240:205–213.
TOOLS
Similar articles