Clinical outcomes of bilateral single-stage unicompartmental knee arthroplasty

Akhtar, Kash; Somashekar, N.; Willis-Owen, Charles A; Houlihan-Burne, David

doi:10.1016/j.knee.2013.05.015

Cited by 22 publications

(27 citation statements)

References 35 publications

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“…The present studies reported that single-staged UKA offers the benefits of a single anesthesia, reduced total anesthetic time, shorter total hospital stay, diminished costs, and absence of necessity for an increase in blood transfusion rates. [ 16 17 18 19 20 ] In our research, we obtained similar results. The average operation time in the SS group was shorter than that in the TS group.…”

Section: Discussionsupporting

confidence: 83%

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Clinical Outcomes and Risks of Single-stage Bilateral Unicompartmental Knee Arthroplasty via Oxford Phase III

Xue

et al. 2015

Chinese Medical Journal

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Background:Osteoarthritis often affects the joint bilaterally, and the single-stage (SS) unicompartmental knee arthroplasty (UKA) is advantageous in terms of a single anesthesia administration, a short hospital stay, lower medical costs, and enhanced patient convenience. However, the complication risk of SS UKA continues to be debated. The aim of this article was to evaluate the clinical effectiveness, complications, and functional recovery of SS and two-stage (TS) UKA.Methods:From January 2008 to December 2013, we compared a series of 36 SS UKA with 45 TS UKA for osteoarthritis. The mean age was 65.4 years (range: 55–75 years). The mean body mass index was 25.2 kg/m2 (range: 22–29 kg/m2). The pre- and post-operative Oxford Knee Scores (OKSs), complications, operative times, tourniquet times, the amount of drainage, and hemoglobin (Hb) were evaluated. The Chi-square test, Fisher's exact test, and paired and grouped t-tests were used in this study.Results:The mean follow-up was 50 months. No complications of death, fat embolism, deep vein thrombosis, and prosthetic infection were reported. Patients who underwent SS UKA had a shorter cumulative anesthesia time (113.5 vs. 133.0 min, P < 0.01). There were no significant variations between the values of the mean tourniquet time, the amount of drainage, pre- and post-operative Hb in the different groups. No patient required a blood transfusion. No statistical differences were found in the complications between two groups (P > 0.05). At the final follow-up, the mean OKS improved from 39.48 ± 5.69 to 18.83 ± 3.82 (P < 0.01), with no statistical differences between the two groups (P > 0.05). Patients who underwent SS UKA had a faster recovery.Conclusions:The single-staged UKA offers the benefits of a single anesthesia administration, reduced total anesthetic time, decreased overall rehabilitation time, and absence of an increase in perioperative mortality or complications compared with the TS bilateral UKA.

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Section: Discussionsupporting

confidence: 83%

“…Though the staged group had more complications than the simultaneous group, there was no significant difference in the results of the statistical analysis. In a report by Akhtar et al .,[ 17 ] 38 patients (76 knees) underwent SS UKA. ASA grade of 3 or below was the only mandatory patient selection index.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Risks of Single-stage Bilateral Unicompartmental Knee Arthroplasty via Oxford Phase III

Xue

et al. 2015

Chinese Medical Journal

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“…The number of studies excluded at each stage of study selection is depicted according to the PRISMA guideline. Following full-text screening, 10 cohort studies12–21 met the inclusion criteria and were included for final analysis. The baseline characteristics of the included articles are provided in table 1.…”

Section: Resultsmentioning

confidence: 99%

Simultaneous bilateral unicompartmental knee arthroplasty surgery has benefits in low complication rate and cost-effectiveness: a systematic review

2020

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ImportanceBilateral knee osteoarthritis is frequent and the best choice of treatment remains questionable, especially when the surgeon has to consider simultaneous or staged bilateral unicompartmental knee arthroplasty (UKA).ObjectiveThe purpose of this systematic review was to conduct a systematic review assessing the clinical outcomes associated with simultaneous bilateral and staged bilateral UKA.Evidence reviewA literature search was conducted in June 2019 in Medline, PubMed and Embase. A full-text review of eligible studies was conducted by two investigators.FindingsA total of 10 retrospective studies were identified. These studies described the results of simultaneous bilateral UKA compared either to staged bilateral UKA or unilateral UKA. Results showed that the prevalence of mortality at a minimum of 30 days postoperatively, deep vein thrombosis, the rate of blood transfusion and reintervention were not higher in patients undergoing a one-stage bilateral UKA. The cost-effectiveness is in favour of doing a one-stage procedure due to the shortness of total hospital stay.Conclusions and relevanceOne-stage simultaneous bilateral UKA can be performed with preventing the postoperative complication, and result in cost savings for patients with symptomatic medial bilateral unicompartmental knee osteoarthritis. Further comparative studies are necessary to determine the best patient profile for such a surgery, and the technical considerations during surgery (consecutive surgery or simultaneous surgery with two operative teams).Level of evidenceIV.

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“…The originator of simultaneous bilateral TKA believes the operation has a wide range of advantages over staged procedures: shorter cumulative anesthesia duration, shorter length of hospital stay, convenience of a single operation, simultaneous rehabilitation training for both knees, high post-operative satisfaction, and lower cost [19–21]. Previous studies of simultaneous bilateral UKA found that patients in the simultaneous operative group had short total length of hospital stay, fewer hospital expenses, and reduced cumulative general anesthesia time [7, 11, 22]. Our study finds similar results.…”

Section: Discussionmentioning

confidence: 99%

“…Physical therapy was performed in 95 patients (76%).Only 4 (3%) patients required skilled care or post-discharge rehabilitation stay. The average hospital stay reported in the Akhtar et al [22] study was 3.5 days. Our study also took longer than European scholars have reported.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the therapeutic effect between the simultaneous and staged unicompartmental knee arthroplasty (UKA) for bilateral knee medial compartment arthritis

Feng

Yang

Sun

et al. 2019

BMC Musculoskelet Disord

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Background To compare the efficacy and safety of simultaneous vs staged unicompartmental knee arthroplasty (UKA) for bilateral unicompartmental osteoarthritis of the knee. Methods We performed a retrospective analysis of prospectively collected data on 93 patients with bilateral knee medial compartment arthritis underwent simultaneous UKA (Group A, 39) or staged UKA (Group B, 54 cases) from January 2008 to December 2015. Group A: 6 males and 33 females aged 64.9 ± 7.7 years; Group B: 5 males and 49 females aged 64.2 ± 6.4 years. There were no statistically significant differences in pre-operative age, sex ratio, or body weight index between the groups ( P > 0.05). Groups were compared in terms of total anesthesia time, volume of drainage, blood transfusion rate, hemoglobin level on post-operative day 3, total post-operative inpatient days, treatment expenses, post-operative therapeutic effect (KSS scores), and complications. Results All patients had follow-up visits post-operatively. The follow-up visit interval was 32–133 months and 41.9 months on average. Total anesthesia time, postoperative length of hospital stay, and hospitalization expenses in Group A were significantly less than those of Group B ( P < 0.05). Hemoglobin levels in Group A were significantly lower than those of Group B at post-op day 3 ( P < 0.05). However, no significant differences in volume of drainage, the rate of transfusion, complications, and KSS scores were detected between Groups A and B ( P > 0.05). Conclusions Both simultaneous and staged UKA achieved the desired therapeutic effect in treatment of bilateral knee medial compartment arthritis. However, simultaneous UKA reduced the cost and the postoperative length of hospital stay without increasing post-operative complications.

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Clinical outcomes of bilateral single-stage unicompartmental knee arthroplasty

Cited by 22 publications

References 35 publications

Clinical Outcomes and Risks of Single-stage Bilateral Unicompartmental Knee Arthroplasty via Oxford Phase III

Clinical Outcomes and Risks of Single-stage Bilateral Unicompartmental Knee Arthroplasty via Oxford Phase III

Simultaneous bilateral unicompartmental knee arthroplasty surgery has benefits in low complication rate and cost-effectiveness: a systematic review

Comparison of the therapeutic effect between the simultaneous and staged unicompartmental knee arthroplasty (UKA) for bilateral knee medial compartment arthritis

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