Is Simultaneous Bilateral Knee Replacement a Safe Approach for Patients with Bilateral Knee Osteoarthritis? A Prospective Case-control Study

Ortop Traumatol Rehabil. 2023 Dec 30;25(6):333-339. doi: 10.5604/01.3001.0054.3271.

Abstract

Background: Total knee arthroplasty (TKA) is the standard treatment for terminal knee osteoarthritis. Simultaneous bilateral total knee arthroplasty (STKA) can be a cost-effective and practical option for patients with degenerative joint disease affecting both knees. The purpose of this study was to assess complication rates and functional outcomes following simultaneous versus staged bilateral total knee replacement.

Material and methods: Approximately 60 individuals who experienced debilitating knee osteoarthritis were enrolled in a prospective study with a randomized comparative design. Out of these, 30 patients underwent simultaneous total knee arthroplasty (STKA), while the remaining 30 individuals underwent two separate surgeries with a gap of 3-6 months between each procedure for both knees. After excluding 7 patients from both groups, a total of 53 patients were included in the study and followed up for at least 12 months.

Results: Pre-operative demographic parameters were equated between both groups. The overall number of systemic complications was higher in the simultaneous group compared with the stagedone. Systemic complications were correlated with the elderly and high-risk populations. However, simultaneous procedures were safe in a low-risk group with shorter hospitalization and operative times.

Conclusions: 1. Simultaneous bilateral total knee arthroplasty (TKA) is considered safe and feasible mainly for younger individuals with ASA 1 or 2 health status. 2. Patients undergoing simultaneous bilateral TKA experience significantly reduced hospital stays. 3. The procedure may not be advisable for elderly patients at a higher risk of systemic complications.

Keywords: arthroplasty; bilateral replacement; knee joint; outcomes.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Case-Control Studies
  • Humans
  • Knee Joint / surgery
  • Osteoarthritis, Knee* / surgery
  • Prospective Studies
  • Treatment Outcome