Long Term Outcomes of Single Staged Sequential Bilateral Total Knee Replacement in Patients Aged 60 Years or Above

Abstract

Objective: To determine the long-term outcomes of single staged bilateral total knee arthroplasty in patients of geriatric age group. Methods: This single-center retrospective study was carried out at Liaquat National Hospital Karachi, Pakistan. Data of 2001 to 2010 were retrieved from the medical records. All geriatric age group patients above 60 years irrespective of comorbidity status, underwent single-stage bilateral total knee arthroplasty were consecutively included. Pre-operative diagnoses such as primary osteoarthritis, post-traumatic arthritis and rheumatoid arthritis were noted. The minimum follow-up time period was 10 years. Long term outcome such as knee society score, adverse event, and need of revision surgery were noted. Results: Of 96 patients, the median age was 69.0 (65.0-76.0) years. There were 44 (45.8%) males and 52 (54.2%) females. Primary osteoarthritis was the most common primary diagnosis, i.e., 66 (68.8%) followed by rheumatoid arthritis in 24 (25.0%), and post-traumatic arthritis in 6 (6.3%) patients. Most of the patients had moderate Charlson Comorbidity Index score, i.e., 70 (72.9%) while Knee Society Score showed that 41 (40%) reported excellent outcome. Need of revision surgery was reported by 6 (6.3%) patients. Adverse events were reported by 11 (11.5%) patients. A significant median difference of Knee Society Score was found among patients with diabetes mellitus (p-value <0.001) and pre-operative diagnosis (p-value <0.001). Conclusion: The long-term outcome of patients underwent bilateral total knee arthroplasty was found satisfactory. It is likely that total knee arthroplasty is widely regarded as the best option for treating end-stage knee osteoarthritis.