Single-staged Bilateral Revision Knee Prosthesis Results

Abstract

Total knee arthroplasty (TKA) can become impaired in the functionality of the bone-prosthetic unit for various reasons, thereby leading to prosthetic loosening. For patients with bilateral aseptic loosening, revision knee arthroplasty surgery is usually performed in different sessions. Today, with developing anesthetic techniques, the patients' intraoperative and postoperative additional medical treatment needs are reduced; there is a reduction in complication rates too. Complications such as laryngospasm, bronchospasm, malignant hyperthermia, respiratory depression, postoperative delirium, or cognitive dysfunction can be seen. In the postoperative period, patient satisfaction, with adequate pain control, makes the rehabilitation of the knee is easier and shortens the duration of hospital stay. In addition, the risks of complications such as deep venous thrombosis, pulmonary embolism, pneumonia, and urinary retention are decreased with early rehabilitation, preventing the development of arthrofibrosis. Maximum recovery in the early postoperative period may be possible with the early recovery of movement. Between the years 2017 and 2018, patients admitted to our hospital for bilateral TKA application due to bilateral aseptic loosening and the early results of the application of bilateral revision TKA in one session with four selected patients are compared according to the requirements for blood transfusion and overall costs. Patient selection was shared with the anesthesiologist and the decision to continue bilaterally was made in the intraoperative assessment. In patients who did not develop any pathologies in the initial operation, the second operation was performed, where the risks of the second operation were not taken into account. As a result, we conclude that bilateral revision TKA application on correct patient selection is a surgical procedure that can be performed safely by an experienced team.