Simultaneous bilateral total knee arthroplasty. A multicenter feasibility study - 05/03/13

Doi : 10.1016/j.otsr.2012.12.015

J.-Y. Jenny ^a,^⁎ , C. Trojani ^b, J.-L. Prudhon ^c, C. Vielpeau ^d, D. Saragaglia ^e, C. Houillon ^e, T. Ameline ^d, F. Steffan ^c, B. Bugnas ^b, J. Arndt ^a
Hip and Knee Surgery French Society (SFHG)
^a Strasbourg University Hospital Group, Division of Ortopaedics and Hand Surgery, 10, avenue Baumann, 67400 Illkirch, France
^b Department of Orthopaedic Surgery, l’Archet Hospital 2, 151, route de Saint-Antoine-de-Ginestière, Nice Teaching Hospital Center, 06202 Nice, France
^c MEDICEDRES, 48, avenue de Grugliasco, 38130 Echirolles, France
^d Côte de Nacre Teaching Hospital Center, Department of Orthopaedics and Traumatology, 14000 Caen, France
^e Academic Division of Orthopaedic Surgery and Sports Traumatology, Grenoble Teaching Hospital Center, Southern Grenoble Hospital, avenue de Kimberley, BP 338, 38434 Echirolles cedex, France

Corresponding author. Tel.: +33 88 55 21 45; fax: +33 88 55 23 57.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Tuesday 05 March 2013
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Summary

Introduction

The value and risk of simultaneous total knee arthroplasty (TKA) in patients with bilateral knee arthritis is a subject of debate.

Hypotheses

The risk of complications following simultaneous bilateral TKA will be increased compared to the rates published in the literature for unilateral TKA, and the clinical and functional outcomes will be poorer in this particular group.

Materials and methods

One hundred and twenty-three patients who underwent simultaneous bilateral TKA between 2005 and 2011 in five specialized, high volume centers were evaluated. The files were analyzed retrospectively after a mean 33months of follow-up.

Results

The mean hospital stay was 11days. Mean blood loss was 4.1g/dL. A postoperative transfusion was performed in 68 patients (55%), with a mean 3.1 units of blood. The mean global IKS score increased from 90 to 150 points. Eighty patients would agree to undergo simultaneous bilateral TKA again (65%), and 70 would recommend this procedure to others (57%).

Discussion

The hypothesis was not confirmed: the risk of complications was not increased compared to the generally accepted risk of a unilateral procedure. The risk of complications in this study was very similar to that published in the literature for the same therapeutic strategy. Therefore, there is no solid medical evidence to prevent recommending this strategy. The results of the participating centers suggest that this therapeutic approach should be continued in selected indications.