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Orthopaedics & Traumatology: Surgery & Research
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le lundi 14 mai 2018
Doi : 10.1016/j.otsr.2018.03.012
Received : 1 December 2017 ;  accepted : 26 Mars 2018
Single-stage bilateral medial Oxford Unicompartmental Knee Arthroplasty: A case-control study of perioperative blood loss, complications and functional results
 

Arnaud Clavé a, b, c, , Emeline Gauthier a, b, Navraj S. Nagra d, François Fazilleau a, b, Anthony Le Sant a, e, Frédéric Dubrana a, b
a Faculté de médecine, université de Bretagne Occidentale, 29200 Brest, France 
b Service d’orthopédie, CHU de la Cavale-Blanche, 29200 Brest, France 
c Oxford Orthopaedic Engineering Centre, NDORMS, University of Oxford, Oxford, UK 
d Oxford University Clinical Academic Graduate School (OUCAGS), Medical Sciences Division, John Radcliffe Hospital, Oxford, UK 
e Service d’orthopédie, hôpital de Morlaix, 29600 Morlaix, France 

Corresponding author at: Service de chirurgie orthopédique et traumatologique, hôpital de la Cavale-Blanche, faculté de médecine de Brest, CHRU de Brest, boulevard Tanguy-Prigent, 29200 Brest, France.Service de chirurgie orthopédique et traumatologique, hôpital de la Cavale-Blanche, faculté de médecine de Brest, CHRU de Brest, boulevard Tanguy-Prigent, 29200 Brest, France.
Abstract
Background

The benefits and risks of a single-stage medial UKA remains a subject of debate because of the theoretically higher risk of complications and specifically blood loss. The aim of this study was to evaluate the perioperative blood loss, risks and the functional results of single-stage bilateral medial Oxford Unicompartmental Knee Arthroplasty (OUKA) compared to a standard unilateral medial OUKA procedure (control group).

Hypothesis

The blood loss observed during bilateral single-stage medial Oxford UKA is not different from that of the control group.

Methods

In this case-control prospective study, fifty patients (100 knees) who underwent single-stage bilateral medial OUKA (study group) were compared to a hundred patients (100 knees) with unilateral medial OUKA (control group), performed by the same surgeon. The real blood loss (in mL of hematocrit at 100%), incidence of blood transfusions, and complication rates were compared. Clinical results were assessed at 6 month and at a two-year minimum follow-up (FU) using IKS, KOOS and OKS scores, in addition to a satisfaction questionnaire.

Results

Groups were deemed comparable. Concerning blood loss, no significant difference was observed compared to the control group (465mL±225 vs. 396±190; p =0.07). No difference was found, either, between groups regarding the complication rates (p =0.36), nor the clinical results (p =0.61) and patient satisfaction (p =0.23) at last FU.

Conclusion

Single-stage bilateral procedure does not cause increased blood loss compared with controls. Moreover, clinical results were deemed good and excellent in spite of a slightly greater complication rate than those found in the literature but similar to controls.

Level of evidence

Case-control study, level III.

The full text of this article is available in PDF format.

Keywords : Knee, Unicompartmental knee arthroplasty, Single-stage bilateral, Blood loss, Complications, Functional results




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