Dimitris Craig N, Taylor Benjamin C, Mowbray John G, Steensen Robert N, Gaines Steven T
Department of Orthopaedic Surgery, Mount Carmel West Hospital, 793 W State St, Columbus, OH 43222, USA.
Orthopedics. 2011 Dec 6;34(12):e841-6. doi: 10.3928/01477447-20111021-02.
Total knee arthroplasty (TKA) has a well-established track record for relieving pain associated with arthritis of the knee joint. The total rate of bilateral TKA has doubled over the past 2 decades, and the rate in women has tripled over that same time period. In patients with bilateral knee arthritis, a decision must be made whether to operate at 2 different settings (staged), a single setting with 1 surgeon (sequential simultaneous), or a single setting with 2 surgeons (2-team simultaneous). The purpose of this study was to examine the perioperative morbidity and mortality of 2-team simultaneous bilateral TKA. Two hundred twenty-seven consecutive 2-team simultaneous bilateral TKA and 216 consecutive unilateral TKA patients were reviewed. Major (deep infection, death, cerebrovascular accident, myocardial infarction, pulmonary embolism, revision within the 1-year follow-up) and minor (all other) complications were compared. No deaths occurred, and the major and minor complication rates were not statistically significantly different between the 2 groups, but a trend toward higher rates of both major and minor complications existed in the bilateral TKA group. Two-team simultaneous bilateral TKA offers the potential benefits of decreased overall recovery time, decreased overall cost, decreased number of anesthetic administrations, and simultaneous correction of significant deformity. It remains an appropriate option in select patients.
全膝关节置换术（TKA）在缓解膝关节关节炎相关疼痛方面有着公认的良好记录。在过去20年中，双侧TKA的总发生率翻了一番，同期女性的发生率增长了两倍。对于双侧膝关节关节炎患者，必须决定是在两个不同的手术环境下分期进行手术，还是由一名外科医生在单一手术环境下连续同时进行手术，或者由两名外科医生在单一手术环境下同时进行手术（双团队同时手术）。本研究的目的是探讨双团队同时进行双侧TKA的围手术期发病率和死亡率。回顾了227例连续的双团队同时进行双侧TKA患者和216例连续的单侧TKA患者。比较了严重（深部感染、死亡、脑血管意外、心肌梗死、肺栓塞、1年随访内翻修）和轻微（所有其他）并发症。未发生死亡，两组之间的严重和轻微并发症发生率无统计学显著差异，但双侧TKA组存在严重和轻微并发症发生率均较高的趋势。双团队同时进行双侧TKA具有总体恢复时间缩短、总体成本降低、麻醉给药次数减少以及同时矫正严重畸形等潜在益处。在特定患者中，它仍然是一个合适的选择。
