Differences in functional recovery after unilateral versus bilateral total knee arthroplasty

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-03-11 DOI:10.1016/j.knee.2025.02.016

Seung Jun Lee , Jun Hwan Choi , Bo Ryun Kim , Yong-Geun Park , So Young Lee , Hyun Jung Lee , Wooseong Jeong

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引用次数: 0

Abstract

Background

Understanding functional changes between unilateral and simultaneous bilateral total knee arthroplasty (TKA) patients remains limited. The purpose of this study was to investigate the differences in recovery times between unilateral and bilateral TKA.

Methods

We retrospectively recruited patients who met the eligibility criteria. All patients engaged in a standard rehabilitation program and completed both self-reported questionnaires and performance-based physical function tests preoperatively, at 6 and 12 weeks postoperatively.

Results

A total of 838 patients were included in this study. Those who underwent bilateral TKA (n = 281) were younger than those opting for unilateral TKA (n = 557), with no significant differences in baseline health status observed between the two groups. Both groups showed continuous improvements in pain, function, and performance-based physical functions from preoperatively to 12 weeks postoperatively. Notably, stiffness did not significantly improve from the preoperative to 6 weeks postoperatively and the stair-climbing test (SCT) showed delayed recovery, with deterioration at 6 weeks but subsequent improvement at 12 weeks in bilateral TKA group. Similarly, the recovery rate in the 6-min walking test (6MWT) was initially slow for the bilateral TKA group during the first 6 weeks, but later accelerated. Significant interactions between time and group were observed in the timed-up-and-go test, 6MWT, and SCT.

Conclusion

Patients who underwent bilateral TKA showed distinct recovery patterns, suggesting the need for tailored rehabilitation approaches compared those who underwent unilateral surgery. These findings underscore the need to provide patients with information about potential differences in recovery patterns based on their chosen surgical approach prior to surgery.

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单侧与双侧全膝关节置换术后功能恢复的差异

背景：对单侧和同步双侧全膝关节置换术（TKA）患者功能变化的了解仍然有限。本研究的目的是探讨单侧和双侧TKA在恢复时间上的差异。方法回顾性招募符合入选标准的患者。所有患者都参与了标准的康复计划，并在术前、术后6周和12周完成了自我报告问卷和基于性能的身体功能测试。结果共纳入838例患者。接受双侧TKA的患者（n = 281）比选择单侧TKA的患者（n = 557）更年轻，两组之间的基线健康状况无显著差异。从术前到术后12周，两组疼痛、功能和基于性能的身体功能均持续改善。值得注意的是，从术前到术后6周，僵硬度没有明显改善，爬楼梯试验（SCT）显示恢复延迟，双侧TKA组在6周时恶化，但随后在12周时改善。同样，双侧TKA组在前6周的6分钟步行测试（6MWT）中恢复速度最初较慢，但随后加快。时间和组之间的显著相互作用观察到的时间-up-and-go测试，6MWT，和SCT。结论双侧TKA患者表现出明显的康复模式，与单侧手术患者相比，需要针对性的康复方法。这些发现强调有必要在手术前根据患者选择的手术方式，向患者提供有关恢复模式潜在差异的信息。

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

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.