全膝关节置换术后恢复：单膝还是双膝重要？

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-05-28 DOI:10.1016/j.jcot.2025.103076

Clevio Desouza , Vijay Shetty

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引用次数: 0

摘要

背景：全膝关节置换术（TKA）是治疗终末期骨关节炎（OA）的有效手术干预手段。由于功能结局、并发症发生率和恢复轨迹的差异，决定单侧TKA和同时双侧TKA仍然是一个有争议的话题。本研究的目的是比较印度人群中单侧和同时双侧TKA的功能恢复、并发症和患者满意度。方法该前瞻性、单外科医生、比较队列研究包括216例患者（112例单侧TKA， 104例同时双侧TKA）。患者平均随访6.15±1.21年。在术后1年和5年使用牛津膝关节评分（OKS）和活动范围（ROM）评估功能结果。疼痛、并发症发生率、住院时间和患者满意度也进行了评估。结果与基线相比，两组患者的OKS和ROM均有显著改善。1年时，OKS分别改善至33.12±1.66（单侧）和33.56±1.72（双侧）（p值= 0.028），5年时进一步改善（38.65±1.48 vs. 39.14±1.54，p值= 0.011）。两组间ROM改善具有可比性（p值= 0.787）。双侧组住院时间较长（p值= 0.02），术后早期疼痛较高，但总体并发症发生率和患者满意度相似（p值= 0.74）。结论同期双侧TKA与单侧TKA的远期功能效果相当，恢复效率高，并发症发生率相似。仔细选择患者对优化结果至关重要。

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Recovery after Total Knee Arthroplasty: Does one or two knees matter?

Background

Total Knee Arthroplasty (TKA) is an effective surgical intervention for end-stage osteoarthritis (OA). The decision between unilateral TKA and simultaneous bilateral TKA remains a topic of debate due to differences in functional outcomes, complication rates, and recovery trajectories. This study aims to compare the functional recovery, complications, and patient satisfaction between unilateral and simultaneous bilateral TKA in the Indian population.

Methods

This prospective, single-surgeon, comparative cohort study included 216 patients (112 unilateral TKA, 104 simultaneous bilateral TKA). Patients were followed for an average of 6.15 ± 1.21 years. Functional outcomes were assessed using the Oxford Knee Score (OKS) and range of motion (ROM) at 1 year and 5 years postoperatively. Pain, complication rates, hospital stay, and patient satisfaction were also evaluated.

Results

Both groups showed significant improvements in OKS and ROM compared to baseline. At 1 year, the OKS improved to 33.12 ± 1.66 (unilateral) and 33.56 ± 1.72 (bilateral) (P-value = 0.028), with further improvement at 5 years (38.65 ± 1.48 vs. 39.14 ± 1.54, P-value = 0.011). ROM improvements were comparable between groups (P-value = 0.787). The bilateral group had a longer hospital stay (P-value = 0.02) and higher early postoperative pain, but overall complication rates and patient satisfaction were similar (P-value = 0.74).

Conclusion

Simultaneous bilateral TKA provides comparable long-term functional outcomes to unilateral TKA, with efficient recovery and similar complication rates. Careful patient selection is essential to optimize outcomes.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.