Institut Universitaire Locomoteur et du sport, Hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, 06000 Nice, France.
Institut Universitaire Locomoteur et du sport, Hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, 06000 Nice, France.
Orthop Traumatol Surg Res. 2020 Sep;106(5):903-906. doi: 10.1016/j.otsr.2020.02.017. Epub 2020 Jul 4.
The early morbidity and mortality of one-session bilateral total knee arthroplasty (1-session BTKA) has been reported in the medical literature. However, there is less information about the long-term clinical impact of this strategy. The aim of this study was to report on the late complications (>90 days), clinical outcomes (KOOS and new KSS) along with the survivorship of 1-session BTKA. We hypothesised that 1-session BTKA will cause few late complications and that the implant survival will meet the criteria of the National Institute for Health and Clinical Excellence (NICE).
This single-centre retrospective study analysed a cohort of ASA-1 and ASA-2 patients who underwent 1-session BTKR over an 8-year period (2009 to 2016). The cohort consisted of 116 patients (66% women, 34% men) with mean age at inclusion of 69 years (32-85 years); 22% of patients were ASA-1 and 78% were ASA-2. The implant-related, infection-related or mechanical complications that occurred more than 90 days after the operation, the clinical outcomes (KOOS and New KSS) and radiological outcomes, along with the survivorship were determined during the scheduled follow-up visits at 3 months, 6 months and 1 year postoperative and during the long-term follow-up or during an intercurrent event.
No patients were lost to follow-up. Fifteen complications occurred (6.5%): four infections, four patellar problems (three cases of clunk syndrome and one of patellofemoral pain), four cases of stiffness, two of unexplained pain and one femoral periprosthetic fracture. Eight patients were readmitted to the hospital (7%); seven were reoperated (3%) and two implants were revised (1%). The functional outcomes (KOOS and New KSS) were significantly improved and 87% of patients were satisfied or very satisfied with this procedure. At a mean follow-up of 5 years, the survivorship estimated using the Kaplan-Meier method was 98.4% (95% CI: 0.933-0.996).
Performing 1-session BTKA is a reliable strategy as it produces a low rate of late complications, excellent medium-term functional outcomes and survivorship that meets NICE criteria, thus confirming our hypothesis.
IV, retrospective case series.
单期双侧全膝关节置换术（1-session BTKA）的早期发病率和死亡率已在医学文献中报道。然而，关于这种策略的长期临床影响的信息较少。本研究的目的是报告>90 天的晚期并发症、临床结果（KOOS 和新 KSS）以及 1-session BTKA 的生存率。我们假设 1-session BTKA 只会引起少数晚期并发症，并且植入物的存活率将符合英国国家卫生与临床优化研究所（NICE）的标准。
这项单中心回顾性研究分析了 8 年间（2009 年至 2016 年）接受 1-session BTKR 的 ASA-1 和 ASA-2 患者队列。该队列包括 116 名患者（66%为女性，34%为男性），纳入时的平均年龄为 69 岁（32-85 岁）；22%的患者为 ASA-1，78%为 ASA-2。在手术 90 天后发生的与植入物相关、与感染相关或与机械相关的并发症、临床结果（KOOS 和新 KSS）和放射学结果，以及在术后 3 个月、6 个月和 1 年的预定随访期间以及在长期随访期间或在并发事件期间确定了生存率。
没有患者失访。发生了 15 例并发症（6.5%）：4 例感染，4 例髌骨问题（3 例弹响综合征和 1 例髌股疼痛），4 例僵硬，2 例不明原因疼痛和 1 例股骨假体周围骨折。8 名患者（7%）再次住院，7 名患者（3%）再次手术，2 名患者（1%）进行了植入物翻修。功能结果（KOOS 和新 KSS）显著改善，87%的患者对该手术满意或非常满意。平均随访 5 年后，使用 Kaplan-Meier 法估计的生存率为 98.4%（95%CI：0.933-0.996）。
进行 1-session BTKA 是一种可靠的策略，因为它产生的晚期并发症发生率低，中期功能结果极佳，且存活率符合 NICE 标准，从而证实了我们的假设。
IV，回顾性病例系列。
