Acta Orthop Belg. 2021 Sep;87(3):487-493.
Safety of simultaneous bilateral TKA (simBTKA) and staged BTKA (staBTKA) have been compared in previous systematic reviews but functional outcome remains neglected aspect of the debate. We performed a systematic review of contemporary literature to compare the functional outcome of simBTKA and staBTKA. We searched PubMed/MEDLINE, EMBASE and Cochrane Central Database to identify all articles published between 2000 and July 2020 that evaluated the outcome of patients undergoing BTKA either in simultaneous or staged manner. Ten articles were identified which met the inclusion criteria. Functional outcome was reported in terms of Knee Society score (KSS), range of motion (ROM), Oxford Knee Score (OKS) and Western Ontario and McMaster University score (WOMAC) in seven, five, four and two studies respectively. KSS gained on average 66.6 points (47.5-95.3) for simBTKA and 65.1 points (44.4-97.2) for staBTKA without significant difference between two groups. There was no difference in post-operative ROM (maximum post-operative flexion being 124.4 and 125.1 for simBTKA and staBTKA groups respectively). Mean improvement in OKS ranged from 20 to 32.6 for simBTKA and 21.6 to 33.1 for staBTKA. There was moderate evidence to suggest that both simultaneous BTKA and staged BTKA produce equivalent improvement in functional scores.
同时双侧全膝关节置换术（simBTKA）和分期全膝关节置换术（staBTKA）的安全性已在先前的系统评价中进行了比较，但功能结果仍然是争论中被忽视的方面。我们对当代文献进行了系统评价，以比较 simBTKA 和 staBTKA 的功能结果。我们检索了 PubMed/MEDLINE、EMBASE 和 Cochrane 中央数据库，以确定 2000 年至 2020 年 7 月期间发表的评估患者同时或分期接受全膝关节置换术的结果的所有文章。确定了符合纳入标准的 10 篇文章。有 7 项、5 项、4 项和 2 项研究分别以膝关节学会评分（KSS）、关节活动范围（ROM）、牛津膝关节评分（OKS）和西部安大略省和麦克马斯特大学评分（WOMAC）来报告功能结果。simBTKA 的平均 KSS 提高了 66.6 分（47.5-95.3），staBTKA 提高了 65.1 分（44.4-97.2），两组之间没有显著差异。术后 ROM 无差异（最大术后屈曲分别为 simBTKA 和 staBTKA 组的 124.4 和 125.1）。simBTKA 的 OKS 平均改善幅度为 20-32.6，staBTKA 为 21.6-33.1。有中等证据表明，同时行 BTKA 和分期行 BTKA 均可使功能评分得到相当程度的改善。
