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Simultaneous bilateral knee arthroplasty: functional outcomes and complications in 22 cases. A prospective single-centre study
ESSKA Academy. Gosnik B. Nov 8, 2019; 284397; epEKA-68 Topic: Joint Replacement
Bostjan Gosnik
Bostjan Gosnik
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Simultaneous bilateral knee arthroplasty: functional outcomes and complications in 22 cases. A prospective single-centre study

ePoster - epEKA-68

Topic: TKA

Gosnik B., Kavcic G., Bajuk M., Bedencic K., Ivka B.
General Hospital Novo Mesto, Novo Mesto, Slovenia

Introduction: A significant portion of patients with knee osteoarthritis suffer from bilateral symptoms and approximately 10% of all knee replacement patients undergo surgery on contralateral joint within 1 year. Indications and patients criteria is not yet fully known due to lack of evidence and scientific studies. However, most authors are in favour of one-stage bilateral surgery in young and healthy adults with advanced symptomatic knee osteoarthritis on both sides.
Aim: The purpose of this study is to obtain more information, whether simultaneous bilateral knee arthroplasty is as safe as unilateral procedures.
Methods: We prospectively studied all patients that underwent one-stage bilateral knee replacement surgery in our institution in the last 10 years. Population consisted of 22 patients (16 man) with mean age 62,9 years and bilateral radiographic arthritic lesions and symptoms. Age, sex, diagnosis, co-morbidity, Oxford Knee Score, WOMAC Score, ASA Score, type of implants and early complications were collected during hospital stay. All patients were operated with medial parapatellar surgical approach, classic or minimal invasive. Operations were performed by 2 different surgeons. Epidural catheter was placed upon patients request and need for postoperative pain management. Blood transfusion was given if symptoms of postoperative anemia were present or in haemoglobin levels under 80.
Results: The majority of patients were ASA 1 and ASA 2, only 5 patients were ASA 3. 14 patients underwent bilateral medial unicondylar knee replacement (UKA), 8 patients got a bilateral total knee (TKA). Mean hospital stay was 11,3 days, mean operative time was 127 minutes and mean postoperative haemoglobin levels were 102. 4 of 22 needed blood transfusion during hospitalisation and 12 were using epidural catheter to monitor perioperative pain. No early postoperative deaths or thromboembolic events were recorded. The average Oxford knee score improved from 17,9 to 41,2 and the WOMAC score from 59,1 to 12,2 at last follow up, respectively. So far we had one revision because of osteoarthritis progression in UKA.
Conclusion: In our experience one-stage bilateral knee replacement is equally safe than two stage procedure. Early and late minor complication rates were very low and we have recorded 0 major complications. From an outcome perspective one stage knee arthroplasty is considered to be more advantageous.
Key words: one-stage bilateral procedure, knee arthroplasty, complications
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