Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv., Fatih, 34093, İstanbul, Turkey.
Int Orthop. 2020 Oct;44(10):2009-2015. doi: 10.1007/s00264-020-04704-9. Epub 2020 Jul 10.
This study aimed to examine the complications by comparing two surgeons simultaneous bilateral total knee arthroplasty (two-surgeon bilateral TKA) to one surgeon sequential bilateral total knee arthroplasty (single-surgeon bilateral TKA).
Two hundred forty-six participants were prospectively randomized into two groups: two-surgeon bilateral TKA and single-surgeon bilateral TKA. While two surgeons performed simultaneous total knee arthroplasty in the two-surgeon bilateral TKA group, one surgeon performed sequentially in the single-surgeon bilateral TKA group. Ninety-day major, and minor complications rate, operative time, estimated blood loss (EBL) and patient-reported outcome measures were analysed.
The two surgeons operated in two-surgeon bilateral TKA group 246 knees in 123 patients, while the single surgeon operated in single-surgeon bilateral TKA group 246 knees of 123 patients. The median operating time was 120 (range 70-151) minutes in the two-surgeon bilateral TKA group and 140 (range 75-190) minutes in the single-surgeon bilateral TKA group (p < 0.001). The median EBL was higher in the two-surgeon bilateral TKA group (p < 0.001). The 90-day complications were two major complications (1.6%) in the two-surgeon bilateral TKA group and 11 (8.9%) in the single-surgeon bilateral TKA group (p = 0.01).
Two-surgeon simultaneous bilateral TKA is a safe method with lower complication rates compared with single-surgeon sequential bilateral TKA and can be preferred for experienced teams. However, peri- and post-operative care is required to decrease the risk of bleeding, particularly in patients undergoing two-surgeon simultaneous bilateral TKA.
This study was retrospectively registered in a public trials registry ( https://clinicaltrials.gov/ , NCT04299516).
本研究旨在通过比较两名外科医生同时进行双侧全膝关节置换术（双外科医生双侧 TKA）与一名外科医生序贯双侧全膝关节置换术（单外科医生双侧 TKA），来探讨并发症。
246 名参与者被前瞻性随机分为两组：双外科医生双侧 TKA 和单外科医生双侧 TKA。在双外科医生双侧 TKA 组中，两名外科医生同时进行全膝关节置换术，而在单外科医生双侧 TKA 组中，一名外科医生依次进行手术。分析 90 天主要和次要并发症发生率、手术时间、估计失血量（EBL）和患者报告的结果测量。
双外科医生在双外科医生双侧 TKA 组中为 123 名患者的 246 个膝关节进行了手术，而单外科医生在单外科医生双侧 TKA 组中为 123 名患者的 246 个膝关节进行了手术。双外科医生双侧 TKA 组的中位手术时间为 120（范围 70-151）分钟，单外科医生双侧 TKA 组为 140（范围 75-190）分钟（p<0.001）。双外科医生双侧 TKA 组的中位 EBL 更高（p<0.001）。双外科医生双侧 TKA 组有 2 例（1.6%）重大并发症，单外科医生双侧 TKA 组有 11 例（8.9%）（p=0.01）。
与单外科医生序贯双侧 TKA 相比，双外科医生同时进行双侧 TKA 是一种安全的方法，其并发症发生率较低，可优先用于经验丰富的团队。然而，需要进行围手术期和术后护理，以降低出血风险，特别是在接受双外科医生同时进行双侧 TKA 的患者中。
本研究在一个公共试验注册处（https://clinicaltrials.gov/，NCT04299516）进行了回顾性注册。
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