S'abonner

Same-day bilateral total knee replacement versus unilateral total knee replacement: A comparative study - 25/11/22

Doi : 10.1016/j.otsr.2022.103301 
Antoine Raffaelli a, Yoann Lévy a, Pascal Boileau b, Christophe Trojani b,
a Service de Chirurgie Orthopédique-Traumatologique-Chirurgie Vertébrale, Institut Universitaire Locomoteur et du Sport, CHU de Nice, Hôpital Pasteur 2, 30, voie Romaine, 06100 Nice, France 
b Institut de Chirurgie Réparatrice Locomoteur & Sports, Groupe Kantys, 7, avenue Durante, 06000 Nice, France 

Corresponding author.

Abstract

Introduction

Bilateral total knee arthroplasty (TKA) in a single session is rarely done in France, mainly due to the increased risk of perioperative and late complications. The primary objective of this study was to compare the complication rates of same-day bilateral TKA (TKA bilat) with that of unilateral TKA (TKA unilat). The hypothesis was bilateral TKA increases the rate of early and late complications in a group of selected patients (ASA 1 or 2, less than 80 years of age).

Material and methods

Retrospective comparative study of 91 bilat TKA and 182 unilat TKA cases operated on between 2009 and 2016 (1 bilat TKA paired with 2 controls). The patients were matched based on age, sex, indication and ASA score. The minimum follow-up was 2 years. Mortality along with early and late complications were documented. The secondary endpoints were implant survival, functional outcomes, and patient satisfaction.

Results

The early mortality rate was zero in both groups. The early complication rate was lower in the bilat TKA group (9%) than in the unilat TKA group (22%) (p<0.001). The late complications did not differ between groups. Implant survival at 5 years was 99% (95% CI=[95.6–99.7]) in the bilat TKA group and 97% (95% CI=[92.8–98.8]) in the unilat TKA group. The autologous blood transfusion rate was 33% in the bilat TKA group and 2.2% in the unilat TKA group (p<0.001). There was no difference between groups in the satisfaction rate or the KOOS and New IKS scores. A larger share of patients in the unilat TKA group (54%) said they had forgotten about their knee than in the bilat TKA group (43%) (p=0.036).

Discussion

There were few early complications in the bilat TKA group. There was no significant difference in the number of late complications, survival, functional scores, or patient satisfaction between the two groups. The transfusion rate was higher in the bilat TKA group, while the forgotten knee rate was higher in the unilat TKA group.

Conclusion

Our hypothesis was not confirmed: in the context of this study, in patients who are ASA 1 or 2, and less than 80 years old, same-day bilateral TKA does not increase the complication rate relative to unilateral TKA.

Level of evidence

III, comparative study of continuous paired cases.

Le texte complet de cet article est disponible en PDF.

Keywords : Knee osteoarthritis, Bilateral total knee arthroplasty, Same-day, Unilateral total knee arthroplasty, Postoperative complications, Satisfaction, Functional scores


Plan


© 2022  Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 108 - N° 8

Article 103301- décembre 2022 Retour au numéro
Article précédent Article précédent
  • Continuous vs. single-shot adductor canal block for pain management following primary total knee arthroplasty: A systematic review and meta-analysis of randomized controlled trials
  • Quentin P. Sercia, Jérémy J. Bergeron, Stéphane Pelet, Étienne L. Belzile
| Article suivant Article suivant
  • Reliability and validity of commonly used patient-reported outcome measures (PROMs) after medial unicompartmental knee arthroplasty
  • Wang Deng, Hongyi Shao, Yixin Zhou, Hua Li, Zhaolun Wang, Yong Huang

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.