Simultaneous bilateral total knee arthroplasty may be safe in selected patients

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-06-13 DOI:10.1016/j.knee.2025.05.024

Rajesh Malhotra , Deepak Gautam , Saurabh Gupta , Jaiben George

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引用次数: 0

Abstract

Background

Simultaneous bilateral total knee arthroplasty (TKA) provides advantages in the form of single anaesthesia, lower cost, and faster overall rehabilitation for patients suffering from bilateral knee pathologies. However, there are concerns regarding the safety of performing simultaneous bilateral TKA. The present study was aimed at comparing the perioperative outcomes of patients undergoing simultaneous and staged bilateral TKA.

Methods

A total of 1696 patients (3392 knees) suffering from bilateral knee arthritis who either underwent a simultaneous (n = 1025) or staged TKA (n = 671) at a single institution were identified retrospectively from our institutional database. Major and minor complications within 90 days of the procedure were compared between simultaneous and staged procedures.

Results

Patients undergoing simultaneous surgery were younger (P < 0.001), had lower ASA score (P < 0.001), and had a lower number of comorbidities (P < 0.001). Overall, complications were comparable in both the groups (staged vs. simultaneous: 17.9% vs. 17.3%, P = 0.794). But after adjusting for the baseline differences, the simultaneous group had a higher risk of complications. When subgroup analysis was performed, in patients younger than 65 years simultaneous surgery did not increase the risk of complications while the risk was almost doubled in patients above 70 years.

Conclusions

Patients undergoing simultaneous bilateral surgery had an increased risk of complications especially when it was performed in patients over 70 years old. Bilateral simultaneous TKA may be safely performed in patients younger than 65 years. In those patients between 65 and 70 years, the slightly increased risk should be discussed with the patient if simultaneous surgery is being considered.

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同时双侧全膝关节置换术在某些患者中是安全的

同时双侧全膝关节置换术（TKA）为双侧膝关节病变患者提供了单次麻醉、更低成本和更快整体康复的优势。然而，对同时进行双侧TKA的安全性存在担忧。本研究旨在比较同时和分阶段双侧TKA患者的围手术期预后。方法从我们的机构数据库中回顾性分析了同一机构同时（n = 1025）或分期（n = 671）双侧膝关节关节炎患者共1696例（3392个膝关节）。同时手术和分期手术比较90 天内的主要和次要并发症。结果同时行手术的患者年龄更小（P <； 0.001），ASA评分更低（P <； 0.001），合并症发生率更低（P <； 0.001）。总体而言，两组的并发症具有可比性（分阶段vs同步：17.9% vs 17.3%, P = 0.794）。但在调整了基线差异后，同期组出现并发症的风险更高。当进行亚组分析时，在65岁 岁以下的患者中，同时手术不会增加并发症的风险，而在70 岁以上的患者中，风险几乎增加了一倍。结论同时行双侧手术的患者发生并发症的风险增加，尤其是年龄在70岁 以上的患者。年龄小于65 岁的患者可安全进行双侧同时TKA。对于年龄在65 - 70 岁之间的患者，如果考虑同时进行手术，应与患者讨论轻微增加的风险。

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.