Long-Term Comparison Safety and Outcomes of Simultaneous, Staggered, and Staged Bilateral Total Knee Arthroplasty.

IF 3.4 2区医学 Q1 ORTHOPEDICS

Journal of Arthroplasty Pub Date : 2024-10-26 DOI:10.1016/j.arth.2024.10.097

Young-Hoo Kim, Jang-Won Park, Young-Soo Jang, Eun-Jung Kim

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引用次数: 0

Abstract

Background: The purpose of this study was to determine the safety and the clinical outcome of simultaneous, bilateral, and staged bilateral total knee arthroplasty (TKA) performed by a single surgeon at one academic institute.

Methods: We prospectively followed and retrospectively compared the results of 7,155 patients (14,310 knees) who had simultaneous bilateral TKA, 6,671 patients (13,342 knees) who had staggered bilateral TKA, and 4,501 patients (9,002 knees) who had staged bilateral TKA. The mean age of the patients was 67, 65, and 69 years, respectively. The mean follow-up was 15.5, 15.3, and 16.1 years, respectively. The prevalence of mortality and complications were assessed in each group. In addition, patients were assessed clinically and radiographically at each follow-up.

Results: The mortality rate (14 patients, 0.2%) of the patients who underwent simultaneous bilateral TKA was similar to those who underwent staggered bilateral TKA (19 patients, 0.3%) and those who underwent staged bilateral TKA (18 patients, 0.4%) (P > 0.05). The major complication (except death) rate (0.8, 0.5, and 0.4%, respectively) and the minor complication rate (20.7, 19, and 19.6%, respectively) were not significantly different among the three groups (P > 0.05). There was no significant difference in the clinical outcomes, radiographic results, revision rate, or survivorship of TKA implants among the three groups (P > 0.05). Transfusion requirements were different among the three groups (10% in the simultaneous bilateral TKA group, 12% in the staggered bilateral TKA group, and 2% in the staged bilateral TKA group).

Conclusions: We found no significant differences among the simultaneous, staggered, and staged bilateral TKA groups, with regard to the mortality, major complication, minor complication, and revision rates; the survival of TKA implants; and clinical and radiographic results after a mean follow-up of 15.5, 15.3, and 16.1 years, respectively.

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同时双侧、交错双侧和分期双侧全膝关节置换术的安全性和疗效的长期比较。

背景：本研究的目的是确定由一家学术机构的一名外科医生实施的同时双侧、交错双侧和分期双侧全膝关节置换术（TKA）的安全性和临床结果：我们对 7,155 名患者（14,310 个膝关节）进行了前瞻性跟踪和回顾性比较，其中 7,155 名患者（14,310 个膝关节）接受了同步双侧 TKA，6,671 名患者（13,342 个膝关节）接受了交错双侧 TKA，4,501 名患者（9,002 个膝关节）接受了分期双侧 TKA。患者的平均年龄分别为 67 岁、65 岁和 69 岁。平均随访时间分别为 15.5 年、15.3 年和 16.1 年。对每组患者的死亡率和并发症发生率进行了评估。此外，每次随访都对患者进行临床和影像学评估：结果：接受同步双侧 TKA 的患者死亡率（14 例，0.2%）与接受交错双侧 TKA 的患者死亡率（19 例，0.3%）和接受分期双侧 TKA 的患者死亡率（18 例，0.4%）相似（P > 0.05）。三组患者的主要并发症（死亡除外）发生率（分别为 0.8%、0.5% 和 0.4%）和次要并发症发生率（分别为 20.7%、19% 和 19.6%）无显著差异（P > 0.05）。三组患者的临床疗效、影像学结果、翻修率和 TKA 植入物的存活率均无明显差异（P > 0.05）。三组患者的输血需求不同（同时双侧TKA组为10%，交错双侧TKA组为12%，分期双侧TKA组为2%）：我们发现，在死亡率、主要并发症、次要并发症和翻修率、TKA 植入物存活率以及平均随访 15.5 年、15.3 年和 16.1 年后的临床和影像学结果方面，同时双侧、交错双侧和分期双侧 TKA 组之间没有明显差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Arthroplasty 医学-整形外科

CiteScore

7.00

自引率

20.00%

发文量

734

审稿时长

48 days

期刊介绍： The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.