Bilateral vs Unilateral Total Knee Arthroplasty: A Patient-Based Comparison of Pain Levels and Recovery of Ambulatory Skills

Powell, Robert S.; Pulido, Pamela A.; Tuason, Mary S.; Colwell, Clifford W.; Ezzet, Kace A.

doi:10.1016/j.arth.2005.08.009

Cited by 64 publications

(45 citation statements)

References 12 publications

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“…These authors have demonstrated excellent patient satisfaction, equivalent pain scores, similar narcotic use, and equivalent walking distance in simultaneous bilateral TKA compared with unilateral or staged procedures [12,24,30]. Although not directly comparable to our results due to the heterogeneity of the measured outcomes, there does appear to be some potential functional benefit of simultaneous knee arthroplasty, whether total or unicompartmental.…”

Section: Discussioncontrasting

confidence: 49%

“…Comparatively, several authors have demonstrated benefit with bilateral simultaneous surgery for total knee arthroplasty [12,24,30]. These authors have demonstrated excellent patient satisfaction, equivalent pain scores, similar narcotic use, and equivalent walking distance in simultaneous bilateral TKA compared with unilateral or staged procedures [12,24,30].…”

Section: Discussionmentioning

confidence: 99%

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Perioperative Complications of Simultaneous versus Staged Unicompartmental Knee Arthroplasty

Berend¹,

Morris²,

Skeels³

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Perioperative Complications of Simultaneous versus Staged Unicompartmental Knee Arthroplasty

Berend¹,

Morris²,

Skeels³

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Simultaneous bilateral TKA is important for a comfortable life in patients with bilateral gonarthrosis [2][3][4][5][6]. There may be angular differences in component placements in longer surgical procedures, but according to the results of our study there were no differences in component alignment between simultaneous bilateral TKA and unilateral TKA.…”

Section: Discussionmentioning

confidence: 34%

“…Total knee arthroplasty is a good option for pain relief and improved function in patients with advanced gonarthrosis. Simultaneous bilateral TKA procedures have increased in patients with bilateral involvement in recent years [2][3][4][5][6]. This provides the patient an early return to daily activities [7].…”

Section: Introductionmentioning

confidence: 99%

Component alignment in simultaneous bilateral or unilateral total knee arthroplasty

Kılınçoğlu

Unay

Akan

et al. 2010

International Orthopaedics (SICOT)

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A bilateral total knee prosthesis procedure can be performed simultaneously in patients with bilateral gonarthrosis. The purpose of this study was to evaluate the differences in component alignment between the simultaneous bilateral TKA and unilateral TKA. A total of 20 patients out of 40 underwent simultaneous bilateral TKA, whereas 20 patients had unilateral TKA. The component alignments were compared radiographically. There was no statistically significant difference in the component alignment between the simultaneous bilateral TKA group and the unilateral TKA group. In conclusion, component alignment of the patients with simultaneous bilateral TKA is similar to that of unilateral TKA.

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“…Patients should be informed of the increased risk of VTE after bilateral TKA, although this additional risk may be outweighed by a reduction in the cumulative recovery time and a lower cumulative risk of developing a prosthetic joint infection. 42,43 Finally, AHRQ's PSI-12 appears to be a useful tool for ascertaining VTE cases and identifying potential opportunities for improvement, when the ''present-on-admission'' status is also available.…”

Section: Discussionmentioning

confidence: 99%

Mechanical and suboptimal pharmacologic prophylaxis and delayed mobilization but not morbid obesity are associated with venous thromboembolism after total knee arthroplasty: A case‐control study

Sadeghi¹,

Romano²,

Maynard³

et al. 2012

Journal of Hospital Medicine

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BACKGROUND:The FDA‐approved dose of low‐molecular‐weight heparin (LMWH) may not provide adequate thromboprophylaxis in morbidly obese patients after total knee arthroplasty (TKA). Suboptimal dosing, delayed initiation, and overreliance on mechanical methods may also limit the effectiveness of thromboprophylaxis.OBJECTIVE:We explored the associations between the type of thromboprophylaxis, obesity, time of mobilization, and undergoing bilateral TKA on development of symptomatic venous thromboembolism (VTE) after TKA.DESIGN/SETTING/PATIENTS:This was a case‐control study of patients undergoing TKA in 15 teaching hospitals between October 2008 and March 2010. Cases were screened using the Agency for Healthcare Research and Quality's Patient Safety Indicator 12 and had objectively documented acute VTE within 9 days of surgery; controls were randomly selected from the same hospital. Multivariable logistic regression was used to analyze risk factors for postoperative VTE, adjusted for age and gender.RESULTS:Among 130 cases with and 463 controls without acute VTE, body mass index (BMI) ranged from 17 to 61 (median = 34). Thromboprophylaxis was LMWH in 284 (48%), warfarin in 189 (32%), both in 55 (10%), and mechanical prophylaxis alone in 120 (20%). Overall, 77% ambulated on day 1 or 2 after surgery. Factors significantly associated with VTE were bilateral simultaneous TKA (odds ratio [OR] = 4.2; 95% confidence interval [CI]: 1.9–9.1), receipt of FDA‐approved pharmacological prophylaxis (OR = 0.5; 95% CI: 0.3–0.8), and ambulation by postoperative day 2 (OR = 0.3; 95% CI: 0.1–0.9). Obesity was neither a significant confounder nor a modifier of these effects.CONCLUSIONS:Severe obesity was not a significant independent predictor for VTE and did not modify the beneficial effect of FDA‐approved pharmacological thromboprophylaxis. Bilateral TKA and failure to ambulate by the second day after surgery were significant risk factors. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine

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Bilateral vs Unilateral Total Knee Arthroplasty: A Patient-Based Comparison of Pain Levels and Recovery of Ambulatory Skills

Cited by 64 publications

References 12 publications

Perioperative Complications of Simultaneous versus Staged Unicompartmental Knee Arthroplasty

Perioperative Complications of Simultaneous versus Staged Unicompartmental Knee Arthroplasty

Component alignment in simultaneous bilateral or unilateral total knee arthroplasty

Mechanical and suboptimal pharmacologic prophylaxis and delayed mobilization but not morbid obesity are associated with venous thromboembolism after total knee arthroplasty: A case‐control study

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