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

Abstract

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.