Bilateral Sequential Total Knee Replacement Versus Unilateral Total Knee Replacement in a High Volume Hospital

Abstract

Background/purpose: Bilateral simultaneous or sequential total knee replacement (TKR) is performed on a portion of patients but the benefits and risks remain controversial. Methods: A total of 89 sequential bilateral TKR (BTKR) patients were compared with 89 unilateral TKR (UTKR) patients in our total joint replacement centre from October 2011 to October 2014. The baseline parameters were matched and postoperative results were compared. Results: The BTKR group had a shorter length of stay per knee (4.8 days vs. 6.5 days) but with a higher total drain output, higher haemoglobin drop, higher transfusion rate, and more postoperative acute retention of urine. Both groups had similar major complication rates and no 90 days mortality. Conclusion: BTKR is a safe surgery in selected patients performed in a high volume hospital with fast-track programme. 中 文 摘 要: 背景/目的: 部分患者選擇進行雙側同時或順次全膝關節置換術，但益處和風險仍然有爭議。 方法: 從2011年10月至2014年10月，將我們全關節置換中心的89例雙側順序全膝關節置換術（BTKR）患者與89例單側全膝關節置換術（UTKR）患者的基線參數匹配後，比較術後結果。 結果: 例雙側順序全膝關節置換術組的每膝關節留院時間較短（4.8天對6.5天），但總引流量較高，血球蛋白下降較多，輸血率較高，術後急性尿瀦留較多。兩組的主要並發症發生率相似，無90天死亡率。 結論: 在大手術量醫院和術後快速程序下，對於選定的患者，雙側順序全膝關節置換術是一個安全的手術。 Keywords: Total knee replacement, Bilateral total knee replacement, Knee osteoarthritis