J Knee Surg 2017; 30(07): 682-686
DOI: 10.1055/s-0036-1597273
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Identifying an Ideal Time Frame for Staged Bilateral Total Knee Arthroplasty to Maximize Functional Outcome

Jared Ze Yang Yeh
1   Duke-NUS Medical School, Singapore
,
Jerry Yongqiang Chen
2   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
,
Wu Chean Lee
2   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
,
Hwei Chi Chong
2   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
,
Hee Nee Pang
2   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
,
Darren Keng Jin Tay
2   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
,
Shi-Lu Chia
2   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
,
Ngai Nung Lo
2   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
,
Seng Jin Yeo
2   Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
› Author Affiliations
Further Information

Publication History

01 March 2016

14 October 2016

Publication Date:
29 November 2016 (online)

Abstract

Compared with staged bilateral total knee arthroplasty (TKA), simultaneous bilateral TKA carries a higher risk of cardiac complications, pulmonary complications, and mortality, especially in patients with preexisting cardiopulmonary disease or advanced age. However, the period of time between staged TKAs that would eliminate these increased risks has yet to be determined. The purpose of this study is to evaluate complication rates and functional outcome in patients who underwent staged bilateral TKA and to determine an optimal time frame for the second knee. The authors retrospectively reviewed 306 patients who underwent staged bilateral TKA between 2002 and 2013. Patients were grouped into 31 to 90, 91 to 180, 181 to 270, and 271 to 365 days interval, where complication and 90-day readmission rates for the second TKA were identified. Patients were also assessed preoperatively and 2 years postoperatively using the Oxford knee score (OKS) and Short-Form (SF)-36. There was no significant difference in complication and 90-day readmission rates between the various groups. The functional outcome of the knees scored 2 years postoperatively using OKS and SF-36 showed comparable results across all four groups. Thus, the authors could not identify an ideal time frame for performing the second TKA with the objective of maximizing functional outcome.

 
  • References

  • 1 Weinstein AM, Rome BN, Reichmann WM. , et al. Estimating the burden of total knee replacement in the United States. J Bone Joint Surg Am 2013; 95 (05) 385-392
  • 2 Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89 (04) 780-785
  • 3 Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res 2009; 467 (10) 2606-2612
  • 4 Vulcano E, Memtsoudis S, Della Valle AG. Bilateral total knee arthroplasty guidelines: are we there yet?. J Knee Surg 2013; 26 (04) 273-279
  • 5 Mangaleshkar SR, Prasad PS, Chugh S, Thomas AP. Staged bilateral total knee replacement--a safer approach in older patients. Knee 2001; 8 (03) 207-211
  • 6 Restrepo C, Parvizi J, Dietrich T, Einhorn TA. Safety of simultaneous bilateral total knee arthroplasty. A meta-analysis. J Bone Joint Surg Am 2007; 89 (06) 1220-1226
  • 7 Brotherton SL, Roberson JR, de Andrade JR, Fleming LL. Staged versus simultaneous bilateral total knee replacement. J Arthroplasty 1986; 1 (04) 221-228
  • 8 Hutchinson JR, Parish EN, Cross MJ. A comparison of bilateral uncemented total knee arthroplasty: simultaneous or staged?. J Bone Joint Surg Br 2006; 88 (01) 40-43
  • 9 Forster MC, Bauze AJ, Bailie AG, Falworth MS, Oakeshott RD. A retrospective comparative study of bilateral total knee replacement staged at a one-week interval. J Bone Joint Surg Br 2006; 88 (08) 1006-1010
  • 10 Meehan JP, Danielsen B, Tancredi DJ, Kim S, Jamali AA, White RH. A population-based comparison of the incidence of adverse outcomes after simultaneous-bilateral and staged-bilateral total knee arthroplasty. J Bone Joint Surg Am 2011; 93 (23) 2203-2213
  • 11 Poultsides LA, Memtsoudis SG, Vasilakakos T. , et al. Infection following simultaneous bilateral total knee arthroplasty. J Arthroplasty 2013; 28 , (8 Suppl): 92-95
  • 12 Bini SA, Khatod M, Inacio MC, Paxton EW. Same-day versus staged bilateral total knee arthroplasty poses no increase in complications in 6672 primary procedures. J Arthroplasty 2014; 29 (04) 694-697
  • 13 Lindberg-Larsen M, Jørgensen CC, Husted H, Kehlet H. Early morbidity after simultaneous and staged bilateral total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2015; 23 (03) 831-837
  • 14 Reuben JD, Meyers SJ, Cox DD, Elliott M, Watson M, Shim SD. Cost comparison between bilateral simultaneous, staged, and unilateral total joint arthroplasty. J Arthroplasty 1998; 13 (02) 172-179
  • 15 Yoon HS, Han CD, Yang IH. Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in terms of perioperative complications. J Arthroplasty 2010; 25 (02) 179-185
  • 16 Parvizi J, Sullivan TA, Trousdale RT, Lewallen DG. Thirty-day mortality after total knee arthroplasty. J Bone Joint Surg Am 2001; 83-A (08) 1157-1161
  • 17 Ritter M, Mamlin LA, Melfi CA, Katz BP, Freund DA, Arthur DS. Outcome implications for the timing of bilateral total knee arthroplasties. Clin Orthop Relat Res 1997; (345) 99-105
  • 18 Chen AF, Rasouli MR, Vegari DN, Huang RC, Maltenfort MG, Parvizi J. Staged bilateral total knee arthroplasty: time of the second side. J Knee Surg 2015; 28 (04) 311-314
  • 19 Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 (05) 373-383
  • 20 Dawson J, Fitzpatrick R, Murray D, Carr A. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg Br 1998; 80 (01) 63-69
  • 21 Ware Jr JE, Sherbourne CD. The MOS 36-item Short-Form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30 (06) 473-483
  • 22 Weale AE, Halabi OA, Jones PW, White SH. Perceptions of outcomes after unicompartmental and total knee replacements. Clin Orthop Relat Res 2001; (382) 143-153
  • 23 Clement ND, MacDonald D, Simpson AH. The minimal clinically important difference in the Oxford knee score and Short Form 12 score after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2014; 22 (08) 1933-1939