Analysis of Interlimb Asymmetry in Patients Undergoing Simultaneous Bilateral Total Knee Arthroplasty

Abstract

Simultaneous bilateral TKA (SBTKA) has been a favored surgical solution due to reduced costs and patient suffering. The purpose of the present study was to investigate the risk factors of asymmetric recovery in patients who underwent SBTKA and whether that affected quality of life. A total of 187 patients undergoing SBTKA were included. During this study, patients underwent physical examination (knee swelling, active range of motion (ROM) of knee and quadriceps strength) and completed three surveys (VAS pain rating, Short Form-36 and requisite information lists in this study). Our results reveal interlimb asymmetries existed at least two years postoperatively. Between-limb differences in active ROM, quadriceps strength, and VAS pain scores were significantly detected in our study. Risk factors included being female, being older, and having high BMI and high levels of anxiety and depression; different diagnosis and different component size could be risk factors. Finally, interlimb differences in VAS pain scores and active ROM were negatively associated with SF-36 scores. However, interlimb differences in swelling and quadriceps strength were unrelated to SF-36 scores. Risk factors of asymmetric recovery should be evaluated and appreciated due to their significant impact on patients’ quality of life. Before performing SBTKA, clinicians should consider possible risk factors and inform patients of asymmetric recovery between limbs, which could help decrease the unnecessary consultations and postoperative patient dissatisfaction.

Risk factors and outcomes in asymmetrical femoral component size for posterior referencing bilateral total knee arthroplasty: a matched pair analysis

“…active ROM, quadriceps strength, and visual analogue scale pain score) between sides in simultaneous bilateral TKA has previously been examined and shown to be associated with risk factors such as female gender, old age, high BMI, high levels of anxiety, diagnostic differences, and different component sizes. We did not analyse these variables in our study; rather we focused on femoral component sizes [ 18 ].…”

The effect of implant size difference on patient outcomes and failure after bilateral simultaneous total knee arthroplasty

“…Other studies, particularly Yang et al, reported that asymmetrical active ROM, quadriceps strength, and visual analogue scale (VAS) pain score in simultaneous BTKA with component asymmetry are associated with risk factors such as old age, female gender and high BMI. 27…”