Survie et facteurs de risque dans les arthroplasties totales de genou uni- versus bilatérales : une étude de registre - 13/04/19

Unilateral versus Bilateral Total Knee Arthroplasty: A registry study on survival and risk factors

Doi : 10.1016/j.rcot.2019.04.008

Bertrand Boyer ^a,^b,^⁎ , Barbara Bordini ^a, Dalila Caputo ^a, Thomas Neri ^c, Susanna Stea ^a, Aldo Toni ^a
^a Laboratorio di Tecnologia Medica, Istituto Ortopedico Rizzoli, Via di Barbiano, 1/10, 40136 Bologna, Italie
^b Inserm, U1059, 42270 Saint-Étienne, France
^c LIBM, CHU de Saint-Étienne, 42055 Saint-Étienne, France

^⁎Auteur correspondant.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 13 April 2019
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Abstract

Background

Bilateral cases, representing at least 25% of total knee arthroplasties (TKA), could convey a statistical bias linked to dependency. Registries allow exploring this issue, susceptible to question surgeon-validated protocols. Do bilateral total knee arthroplasties behave differently than unilateral knees in terms of implant survival?

Hypothesis

Bilateral TKA have a better survival than unilateral TKA.

Patients and methods

A total of 14,652 bilateral and 27,440 unilateral TKAs were compared. Influencing factors were tested with hazard ratios applied on bilateral knees.

Results

Bilateral knees had a better survival (p<0.001). Delay between first and second side surgeries had an influence on survival of the first knee: if below a year, the first knee survival was superior to the second knee; more than three years between both arthroplasties significantly decreased the survival of the first implant. If the first knee was revised, the hazard ratio for revision of the second implant was 3.5.

Discussion

Series should include separate evaluations of bilateral cases, because they have a better survival than unilateral knees. A long delay between both knee replacements could impact both implant survivals.

Level of evidence

III, cohort comparative study.

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Keywords : Total knee arthroplasty, Bilateral, Registry, Survival

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.