Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv., 34093, Fatih/Istanbul, Turkey.
Orthopade. 2022 Mar;51(3):239-245. doi: 10.1007/s00132-021-04183-9. Epub 2021 Nov 4.
Two-surgeon, simultaneous bilateral total knee arthroplasty (TKA) is considered as an unpredictable, complex procedure in terms of its radiographic and functional outcomes because of different surgeons and teams, and too many instruments and hands in a narrow space. We compared radiological and functional results of simultaneous bilateral TKA and single-surgeon sequential bilateral TKA.
The 136 participants with a minimum of 24 months follow-up were prospectively randomized into 2 groups: two-surgeon bilateral TKA and single-surgeon bilateral TKA. We prespecified primary outcome of the study as between-group differences in terms of component alignment in the coronal and sagittal planes. Short-term functional outcomes were evaluated prospectively using the Oxford Knee Score (OKS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
Each group consisted of 136 knees of 68 patients. The mean tibial medial angles (TMA) were 89° ± 3 ° and 88° ± 5° in two-surgeons and single surgeon groups, respectively (p = 0.24). Radiological outcomes showed that the mean femoral lateral angles (FLA) were 87.9 ± 3.5° and 85.84 ± 3.7° (p = 0.12), posterior tibial slope angles (PTSA) were 8.2 ± 16.9° and 7.6 ± 17.8° (p = 0.84), and femoral flexion angles (FFA)were 86.8 ± 3.8° and 86.3 ± 3.5° (p = 0.41), anterior femoral offset ratios (AFOR) (%) were 29.5 ± 11.1 and 27.7 ± 7.9 (p = 0.31), and posterior femoral offset ratio (PFOR) (%) were 108.41 ± 31.3 and 108.45 ± 25.7 (p = 0.98), respectively.
Two-team simultaneous bilateral TKA is as safe as single stage one-surgeon sequential bilateral TKA in terms of short-term component radiological and the functional outcomes.
由于不同的外科医生和团队，以及在狭窄空间中使用过多的器械和手，双膝关节置换术（TKA）的双关节同时手术被认为是一种不可预测的复杂手术，其影像学和功能结果也存在差异。我们比较了同时双侧 TKA 和单关节双侧 TKA 手术的影像学和功能结果。
136 名患者至少随访 24 个月，前瞻性随机分为两组：双关节双侧 TKA 和单关节双侧 TKA。我们将研究的主要结果定义为两组在冠状面和矢状面的关节面假体对线方面的差异。短期功能结果采用牛津膝关节评分（OKS）和西部安大略省和麦克马斯特大学骨关节炎指数（WOMAC）进行前瞻性评估。
每组各有 68 名患者的 136 个膝关节。双关节组和单关节组的胫骨内侧角（TMA）平均分别为 89°±3°和 88°±5°（p=0.24）。影像学结果显示，股骨外侧角（FLA）平均分别为 87.9°±3.5°和 85.84°±3.7°（p=0.12），胫骨后倾角（PTSA）平均分别为 8.2°±16.9°和 7.6°±17.8°（p=0.84），股骨前倾角（FFA）平均分别为 86.8°±3.8°和 86.3°±3.5°（p=0.41），前侧股骨偏移比（AFOR）（%）平均分别为 29.5±11.1 和 27.7±7.9（p=0.31），后侧股骨偏移比（PFOR）（%）平均分别为 108.41±31.3 和 108.45±25.7（p=0.98）。
就短期关节面假体的影像学和功能结果而言，双关节双侧 TKA 与单关节双侧 TKA 一样安全。
