Bilateral total knee arthroplasty in a one-stage surgical procedure

Trojani, Christophe; Bugnas, B.; Blay, Michel; Carlès, Michel; Boileau, Pascal

doi:10.1016/j.otsr.2012.08.003

Cited by 21 publications

(11 citation statements)

References 39 publications

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“…They concluded that the simultaneous bilateral TKA is both more cost-effective and safe than staged bilateral TKA [12]. The safety of simultaneous bilateral TKA has been noted in some other studies [13][14][15].…”

Section: Discussionmentioning

confidence: 89%

Simultaneous bilateral total knee arthroplasty in patients with haemophilia: a safe and cost‐effective procedure?

et al. 2015

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Section: Discussionmentioning

confidence: 89%

Simultaneous bilateral total knee arthroplasty in patients with haemophilia: a safe and cost‐effective procedure?

et al. 2015

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“…The need for only a single anaesthesia and single surgery has always been the main advantage of SSBTR, while prolonged operating time and blood loss leading to increased morbidity has been the disadvantages [1,2,3,4] . Preoperative evaluation is paramount in selection of patients for SSBTR.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of intraoperative or immediate postoperative complications were analysed with respect to these determinants. Based on previous studies, the complications looked for were need for transfusions, deep vein thrombosis, Pulmonary embolism and cardiovascular complications [1,2,3,17,18,19,20] . In addition, we also looked into the incidence of other factors such as need for ICU stay, infection, electrolyte imbalances, acid base disorders, extended hospital stay and mortality.…”

Section: Methodsmentioning

confidence: 99%

“…The advantages of SSBTR has been outlined to be the need for only a single surgery, single anaesthesia, simultaneous and symmetrical rehabilitation of both knees and cost effectiveness. On the other hand the disadvantages are mainly increased morbidity due to cardiopulmonary insult, need for transfusions, incidence of DVT and Pulmonary Embolism [1,2,3,17,18,19,20] . The aim of this study was to do a retrospective review of the complications during the intraoperative and immediate postoperative period in cases of SSBTR done in our institution.…”

Section: Introductionmentioning

confidence: 99%

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Review of safety of single stage bilateral total knee replacement with cruciate retaining prosthesis and subvastus approach

George¹,

Sainulabdeen²,

Chittaranjan³

et al. 2020

Int. J. Orthop. Sci.

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Background: With Most patients with Osteoarthritis needing bilateral TKR for optimal functional results, the debate on whether to do a single stage bilateral TKR or staged bilateral TKR has become common. The aim of this study was to review the safety of single stage bilateral TKR done in our institution. Materials and Methods: We did a retrospective review of 127 cases of single stage bilateral TKR that was done in our institution during a period of 38 months from 2015 to 2018.Electronic medical Records of patients who underwent single stage Bilateral TKR during this period were reviewed. Only patients who received cruciate retaining prosthesis and had subvastus approach were included. Results were analysed using Chi square testing in terms of ASA grade and age and incidence of complications. Results: ASA grade and age was seen to be correlating with incidence of complications during the intraoperative and immediate postoperative period. The incidence of complications was 42.9% in the ASA-III group with p value less than 0.00001. The Incidence of complications was 16 % in the above 70 years age group with P value less than 0.00982. In the ASA-III group, the incidence was 50% in the above 70 group when compared to the 60-70 group (40%) with P value of less than 0.00001. Conclusions: Judicious patient selection using ASA grade and age may minimise complications of single stage bilateral TKR. The use of Cruciate retaining prosthesis and subvastus approach may have contributed to the low incidence of complications.

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“…In particular, elderly patients and ASA class 3 or 4 patients have a major risk of severe complications [ 15 ]. However, in selected ASA class 1 or 2 patients, no perioperative death or pulmonary embolism was observed in one-stage bilateral TKA [ 25 ]. In this study, we also performed one-stage bilateral TKA in selected patients who were ASA class 1 or 2, and no major complications occurred.…”

Section: Discussionmentioning

confidence: 99%

Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients

et al. 2018

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BackgroundAn increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patients.MethodsSixty-seven patients who received one-stage bilateral TKAs for osteoarthritis who were American Society of Anesthesiology (ASA) class 1 or 2 were included in this study. Perioperative complications, blood loss, transfusion rate, blood laboratory results, and clinical results were evaluated up to 1 year after surgery.ResultsNo major complications (deep infection, pulmonary embolism, cerebrovascular accident, myocardial infarction, death, or removal or revision of the implants) were observed. The average total blood loss was 1139.5 ml. The transfusion rate was 95.5%. Postoperative hemoglobin level and C-reactive protein level gradually improved up to postoperative day 21 (P < 0.01). Bilateral knee extension knee angles and clinical scores improved postoperatively as compared with preoperative values (P < 0.01).ConclusionsAlthough total blood loss and transfusion rate can be high, this preliminary case series suggested that the one-stage bilateral TKA in ASA class 1 or 2 patients can have high perioperative safety levels, and good clinical results can be obtained up to 1 year after surgery. If low-risk patients are selected for bilateral TKA, a one-stage procedure can be beneficial for patients, with a minimal increase in the risk of complications.

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Bilateral total knee arthroplasty in a one-stage surgical procedure

Abstract: 4, prospective, no control group.

Cited by 21 publications

References 39 publications

Simultaneous bilateral total knee arthroplasty in patients with haemophilia: a safe and cost‐effective procedure?

Simultaneous bilateral total knee arthroplasty in patients with haemophilia: a safe and cost‐effective procedure?

Review of safety of single stage bilateral total knee replacement with cruciate retaining prosthesis and subvastus approach

Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients

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