Sydney Orthopaedic Research Institute, Level 1 The Gallery, 445 Victoria Avenue, Chatswood, NSW, 2067, Australia.
Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia.
Knee Surg Sports Traumatol Arthrosc. 2018 Nov;26(11):3395-3402. doi: 10.1007/s00167-018-4908-4. Epub 2018 Mar 24.
The benefits of simultaneous bilateral total knee arthroplasty (SBTKR) include reduced hospital costs, single anaesthetic exposure and in many cases is also the patient's preference. Despite these potential benefits, risk-adversity with respect to assumed complications and mortality make it difficult for the orthopaedic surgeon and patient to make an informed decision. This study aimed to address the inconsistencies and lack of consensus in previous literature regarding the short-term complications and clinical safety of SBTKR in patients with end-stage knee osteoarthritis (OA).
A cohort of 950 knees (475 patients) undergoing surgery between 2008 and 2013 was extracted from a prospectively collected clinical database and retrospectively linked to the Australian Joint Replacement Registry and hospital records. Patients underwent sequential SBTKR by their treating surgeon under one anaesthetic. Basic demographic data and outcome data including complications and mortality were collected. All data were analyzed using descriptive statistics only.
A total of 413 patients and 826 knees were included. The average age of the cohort was 70 years with range between 46 and 88 years. 50% of patients were female. The overall mortality rate during the study follow-up period was 1.9%, with an average time to death postoperatively of 23.8 months. There were no cases of acute postoperative mortality (< 6 weeks). Medical complication rates were low.
In contrast to the higher mortality and complication rates suggested in previous literature, this study has demonstrated that SBTKR is safe, with low mortality and complication rates under the current surgical protocol.
IV.
同期双侧全膝关节置换术（SBTKR）的优点包括降低医院成本、单次麻醉暴露，且在许多情况下也是患者的首选。尽管有这些潜在的好处，但由于假定的并发症和死亡率的风险，使得骨科医生和患者难以做出明智的决定。本研究旨在解决之前文献中关于终末期膝关节骨关节炎（OA）患者 SBTKR 的短期并发症和临床安全性方面的不一致和缺乏共识的问题。
从一个前瞻性收集的临床数据库中提取了 950 例膝关节（475 例患者）的队列，并回顾性地与澳大利亚关节置换登记处和医院记录相关联。患者由其主治医生在一次麻醉下接受序贯 SBTKR。收集了基本人口统计学数据和结果数据，包括并发症和死亡率。所有数据仅采用描述性统计进行分析。
共纳入 413 例患者和 826 例膝关节。队列的平均年龄为 70 岁，范围为 46 至 88 岁。50%的患者为女性。在研究随访期间，总死亡率为 1.9%，术后平均死亡时间为 23.8 个月。没有术后急性死亡（<6 周）的病例。医疗并发症发生率较低。
与之前文献中提到的更高的死亡率和并发症发生率相比，本研究表明，在当前的手术方案下，SBTKR 是安全的，死亡率和并发症发生率较低。
IV。
