TITLE

Safety of Simultaneous Bilateral Total Knee Arthroplasty

AUTHOR(S)
Restrepo, Camilo; Parvizi, Javad; Dietrich, Thomas; Einhorn, Thomas A.
PUB. DATE
June 2007
SOURCE
Journal of Bone & Joint Surgery, American Volume;Jun2007, Vol. 89-A Issue 6, p1220
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The safety of simultaneous bilateral total knee replacement remains controversial. Some studies have demonstrated a higher rate of serious complications, including death, following bilateral procedures, whereas others have suggested no increase in the complication rate. The objective of this meta-analysis was to compare the safety of simultaneous bilateral total knee replacement with that of staged bilateral and unilateral total knee replacements. Methods: A computerized literature search was conducted to identify all citations, from 1966 to 2005, concerning bilateral total knee replacement. All of the English-language abstracts were obtained. A multistage assessment was then performed to identify articles fulfilling the inclusion criteria for the study. All randomized, prospective studies re- porting the outcome of bilateral total knee replacement were included. The details of the reported data were extracted, and an extensive analysis of relevant variables was carried out. Results: One hundred and fifty published articles were identified, and eighteen that included a total of 27,807 patients (44,684 knees) were included in the meta-analysis. There were 10,930 unilateral total knee replacements, 16,419 simultaneous bilateral total knee replacements, and 458 staged bilateral total knee replacements with at least three months between the operative procedures. The prevalences of pulmonary embolism (odds ratio = 1.8), cardiac complications (odds ratio = 2.49), and mortality (odds ratio = 2.2) were higher after simultaneous bilateral total knee replacement. The prevalence of deep venous thrombosis was lower after simultaneous bilateral total knee replacement, but this difference was not significant. The complication rates after the staged bilateral total knee re- placements were similar to those in the patients who had undergone unilateral total knee replacement only. Conclusions: Compared with staged bilateral or unilateral total knee replacement, simultaneous bilateral total knee replacement carries a higher risk of serious cardiac complications, pulmonary complications, and mortality. The period of time between staged procedures that would eliminate these increased risks could not be determined from this study. Level of Evidence: Therapeutic Level Ill. See Instructions to Authors for a complete description of levels of evidence.
ACCESSION #
25315542

 

Related Articles

  • Saw-Tooth Fracture in Total Knee Arthroplasty. Tang, W. M.; Ky Chiu; Ng, T. P. // Orthopedics;Mar2004, Vol. 27 Issue 3, p325 

    Presents cases of intraoperative saw-tooth fracture in patients who have undergone total knee arthroplasty. Causes of saw-tooth fracture; Information on third-body wear in knee arthroplasty.

  • A novel technique to preserve range of motion in two-stage revision of infected total knee arthroplasty. Carulli, Christian; Villano, Marco; Civinini, Roberto; Matassi, Fabrizio; Nistri, Lorenzo; Innocenti, Massimo // International Orthopaedics;Jun2013, Vol. 37 Issue 6, p1069 

    Purpose: Two-stage revision represents the gold standard in the treatment of infected total knee arthroplasty. Different techniques have been proposed, mostly not preserving range of motion. An articulated antibiotic-loaded cement spacer made in association with two unicompartmental implants has...

  • Anterior knee pain following total knee replacement caused by isolated Paget's disease of patella. Gupta, Rohit; Canty, Steve; Ryan, William G. // Internet Journal of Orthopedic Surgery;2008, Vol. 9 Issue 2, p7 

    We as a routine do not resurface the patella during a total knee replacement in our hospital. I present below a case where we had to do so because the patient developed anterior knee pain following a total knee replacement that was diagnosed as arising from isolated Paget's disease of the...

  • Total knee replacement and health-related quality of life: factors influencing long-term outcomes.  // International Journal of Advances in Rheumatology;2009, Vol. 7 Issue 4, p129 

    Is total knee replacement (TKR) for osteoarthritis equally effective in all patients? This Spanish group prospectively followed TKR patients and confirmed that the procedure conferred substantial benefit across the board; however, the gains were reduced in patients who were female or obese.

  • Modified gap-balancing technique in total knee arthroplasty: evaluation of the post-operative coronal laxity. Moro-oka, Taka-aki; Shiraishi, Hirokazu; Iwamoto, Yukihide; Banks, Scott A. // Knee Surgery, Sports Traumatology, Arthroscopy;Mar2010, Vol. 18 Issue 3, p375 

    It is unknown how intra-operative soft-tissue balance affects post-operative knee kinematics during different functional tasks. In order to clarify this relationship, the intra-operative varus–valgus balance and post-operative knee kinematics were compared for 17 patients who underwent...

  • THE FUNCTIONAL OUTCOMES OF TOTAL KNEE ARTHROPLASTY. Kane, Robert L.; Saleh, Khaled J.; Wilt, Timothy J.; Bershadsky, Boris // Journal of Bone & Joint Surgery, American Volume;Aug2005, Vol. 87-A Issue 8, p1719 

    Background: As an elective procedure, total knee arthroplasty is under scrutiny to evaluate its cost-effectiveness. In this review, we examined the available literature on total knee arthroplasty to assess the evidence regarding factors associated with better functional outcomes. Methods: A...

  • COMPARISON OF THE VASTUS-SPLITTING AND MEDIAN PARAPATELLAR APPROACHES FOR PRIMARY TOTAL KNEE ARTHROPLASTY: A PROSPECTIVE, RANDOMIZED STUDY. KELLY, MATTHEW J.; RUMI, MUSTASIM N.; KOTHARI, MILIND; PARENTIS, MICHAEL A.; BAILEY, KATRINA J.; PARRISH, WILLIAM M.; PELLEGRINI JR., VINCENT D. // Journal of Bone & Joint Surgery, American Volume;Apr2006, Vol. 88-A Issue 4, p715 

    Background: A vastus-splitting approach for total knee arthroplasty has been advocated to preserve function of the extensor mechanism and to decrease the prevalence of lateral release. Critics have claimed that there is greater blood loss and compromised exposure in large patients who are...

  • Discussing Treatment Options. Capozzi, James D.; Rhodes, Rosamond; Chen, Darwin // Journal of Bone & Joint Surgery, American Volume;Mar2009, Vol. 91-A Issue 3, p740 

    A sixty-year-old man presented to an orthopaedic surgeon with a periprosthetic infection after total knee arthroplasty performed by another surgeon. He underwent removal of the components, placement of an antibiotic spacer, and antibiotic suppression therapy. Eight weeks later, a revision total...

  • Late spontaneous haemarthrosis: an unusual complication following an unicompartmental knee arthroplasty. Raet, Jan; Verhaven, Eddy; Kemnitz, Stefan // Knee Surgery, Sports Traumatology, Arthroscopy;Jun2007, Vol. 15 Issue 6, p763 

    A man, aged 55, presented with a spontaneous haemarthrosis of his right knee, 1 year after an unicompartmental knee replacement. This case showed an atraumatic rupture of the metal marker wire of an all-polyethylene inlay tibial implant which caused a destruction of the polyethylene surface and...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics