Early morbidity and mortality after single-stage bilateral total knee replacement

Lévy, Yoann; Azar, Michel; Tran, Laurie; Boileau, Pascal; Bronsard, Nicolas; Trojani, Christophe

doi:10.1016/j.otsr.2018.08.007

Cited by 14 publications

(5 citation statements)

References 20 publications

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“…Lévy et al. [ 73 ] recently described early major and minor complication rates of single-staged bilateral TKA during the first 90 days postoperatively, reporting rates within the range of our cohort with respect to mortality (0%), major complications (4.3%), and minor complications (11%). Mortality rates (0.3%), minor (22.8%) and major complications (4.3%), and patient satisfaction (willingness to undergo single-staged bilateral TKA: 73% definitely yes, 22% probably yes; 98.0% yes in our cohort) reported by Putnis et al.…”

Section: Discussionsupporting

confidence: 63%

“…A major downside of having the same patient as the control in a bilateral TKA study is the inability to compare variables such as total cost, length of stay, systemic complications, survival, and readmissions. The geographically localized sample size in our study was relatively small and may be underpowered for some variables due to relatively low complication rates for TKA in general [ 73 , 74 ]. Increasing experience of the attending during the extended study period may also potentially influence differences observed with residents.…”

Section: Discussionmentioning

confidence: 99%

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Does Resident Participation Influence Surgical Time and Clinical Outcomes? An Analysis on Primary Bilateral Single-Staged Sequential Total Knee Arthroplasty

et al. 2022

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Does Resident Participation Influence Surgical Time and Clinical Outcomes? An Analysis on Primary Bilateral Single-Staged Sequential Total Knee Arthroplasty

et al. 2022

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“…[5] The previous research has shown that variables such as cemented or uncemented arthroplasty, surgical technique, anesthesia type, and surgeon preferences can all affect blood loss. [6,7] We attempted to monitor these variables as much as possible when designing our research. We included only cemented arthroplasty procedures in our study.…”

Section: Discussionmentioning

confidence: 99%

A randomized, non-crossover, parallel-group analysis of tranexamic acid in minimizing blood loss and transfusions in total knee arthroplasty

Mudgalkar¹

2021

AUJMSR

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Objectives: Total knee arthroplasty is associated with significant blood loss, necessitating blood transfusions. Due to the obvious risks and costs of allogeneic blood transfusions, techniques to minimize blood loss in surgery are needed. The objective of this study was to assess the efficacy of tranexamic acid treatment in reducing blood loss and blood transfusion requirements during total knee arthroplasty. Materials and Methods: A prospective, randomized, double-blind, parallel-group, non-crossover trial was carried out in Prathima Hospital, Karimnagar. The trial involved 28 ASA I and II patients undergoing unilateral knee arthroplasty, 14 in each of the control and study groups. In the study group, a 10 mg/kg bolus of tranexamic acid was administered slowly IV 30 min before tourniquet deflation, followed by a 1 mg/kg/hr infusion for 12 h, compared to the standard medical treatment in the control group. Total blood loss during and after surgery was compared between the two classes. We also compared the hemoglobin drop after surgery, the number of people who needed blood transfusions, and the number of units needed between the two classes. Any complications were also reported. Results: Total blood loss in the tranexamic acid group was 543.3 ± 184.85 versus 685.83 ± 176.74, a statistically significant difference (P < 0.05). Intraoperative blood loss was comparable, but post-operative blood loss was significantly lower in the tranexamic acid group (389.16 ± 174 ml vs. 514.36 ± 143.89 ml), indicating that it was statistically significant (P < 0.05). There were no complications reported from any of the groups. Conclusion: Tranexamic acid is an effective strategy for minimizing overall blood loss and blood transfusions in patients undergoing total knee arthroplasty.

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“…One stage (or single/same stage) bilateral knee replacement has been reported extensively, but most of the literatures focus on TKR instead of UKR. [13][14][15][16][17][18][19][20][21] The advantages include single operation and anesthesia, [13][14][15][16][22][23][24][25][26] overall faster recovery and shorter total LOS, thereby reducing the financial cost. 14,[22][23][24][25][26] However, there are still a lot of debates about the safety of one stage bilateral TKR.…”

Section: Discussionmentioning

confidence: 99%

“…14,[22][23][24][25][26] However, there are still a lot of debates about the safety of one stage bilateral TKR. Some studies showed more transfusion was required, 14,20 more medical complications and mortality [17][18][19][20][21] while some showed no increased risk 13,15,16 compared with staged operation.…”

Section: Discussionmentioning

confidence: 99%

One stage bilateral unicompartmental knee replacement: Similar early clinical outcome with shorter rehabilitation and better resources utilization compared with two stage

Tang¹,

Wong²,

Wong³

2020

Journal of Orthopaedics, Trauma and Rehabilitation

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Introduction: There are a lot of debates on the advantages and safety profile of one stage bilateral knee arthroplasty. Most of the studies focus on total knee replacement, and it may not be applied directly to unicompartmental knee replacement (UKR). We would like to compare the early results of one and two stage bilateral UKR in our center. Methods: This is a retrospective review of all the bilateral medial UKR done in our center in 2018–2019. Patients’ demographic data, operative time, postoperative blood, length of stay (LOS) and complications were recorded. The number of admissions, pre-operative assessment sessions (PAS), and weeks of post-operative physiotherapy were analyzed. Clinical outcome was measured by Knee society knee score and range of motion (ROM). Results: Our center performed 97 UKR in 2018–2019, with 50 UKR performed in 25 patients, among which 16 received one stage while 9 received two stage bilateral UKR. Both groups had similar mean age, BMI, sex ratio, ASA grading, pre-operative knee score and ROM. Patient in the one stage group required only 1 PAS/admission/operation to treat both knees with a mean LOS of 7.3 days and 7.8 weeks of physiotherapy, while those in the two stage group required 2 PAS/admissions/operations with a mean cumulative LOS of 9.8 days and 14.1 weeks of physiotherapy. The mean cumulative operative time was similar for both groups but the one stage group only required 1 operative session. There was no difference in blood loss and there was no transfusion or complication. The post-operative knee score and ROM at 3 and 6 months were similar for both groups. Conclusion: In suitable patients with bilateral medial OA knee, one stage bilateral UKR offers simliar early clinical outcome with shorter rehabilitation duration but without increasing complications compared with two stage. Resources can therefore be better utilized.

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Early morbidity and mortality after single-stage bilateral total knee replacement

Cited by 14 publications

References 20 publications

Does Resident Participation Influence Surgical Time and Clinical Outcomes? An Analysis on Primary Bilateral Single-Staged Sequential Total Knee Arthroplasty

Does Resident Participation Influence Surgical Time and Clinical Outcomes? An Analysis on Primary Bilateral Single-Staged Sequential Total Knee Arthroplasty

A randomized, non-crossover, parallel-group analysis of tranexamic acid in minimizing blood loss and transfusions in total knee arthroplasty

One stage bilateral unicompartmental knee replacement: Similar early clinical outcome with shorter rehabilitation and better resources utilization compared with two stage

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