Sarzaeem Mohammad Mahdi, Amoozadeh Omrani Farzad, Omidian Mohammad Mahdi, Sahebalzamani Mohammad Ali, Maniei Ehsan
Department of Orthopedic Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences (SBUMS), Tehran, Iran.
Department of Biomaterials, Faculty of Biomedical Engineering, Science and Research, Branch, Islamic Azad University, Tehran, Iran.
Arch Bone Jt Surg. 2021 Nov;9(6):641-646. doi: 10.22038/ABJS.2021.48053.2379.
This retrospective study aimed to compare the clinical outcomes of patients with staged and simultaneous bilateral total knee arthroplasty (TKA).
The present study included 100 patients with a mean age of 62±3.72 years from 2014 to 2017. Among them, 51 and 49 patients underwent simultaneous and staged bilateral TKA, respectively. The two groups were compared regarding the range of motion (ROM), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) improvement, and Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) scores. The mean follow-up duration was 24 months (range: 12-36 months).
According to the results obtained from the SF-36 questionnaire (possessing eight different factors of quality of life), there was no significant difference between the two groups. Furthermore, the OKSs were 39.98±1.52 and 38.68±2.55 in the simultaneous and staged groups, respectively. Moreover, the WOMAC improvement scores were obtained at 84.15±2.2 and 83.26±2.6 in the simultaneous and staged groups, respectively. The final knee ROM was acceptable without a significant difference between the two groups.
Substantial controversy about the complications, functional, and clinical outcomes has negatively affected the decision of the surgeons on conducting bilateral sequential TKA. This clinical assessment revealed that all determinants, including OKS, WOMAC, SF-36, ROM, postoperative bleeding, and hospitalization duration exhibited almost the same improvement in both groups. According to this study, no statistically significant difference exists in both procedures.
本回顾性研究旨在比较分期双侧全膝关节置换术（TKA）和同期双侧全膝关节置换术患者的临床结局。
本研究纳入了2014年至2017年期间平均年龄为62±3.72岁的100例患者。其中，分别有51例和49例患者接受了同期双侧TKA和分期双侧TKA。比较两组患者的活动范围（ROM）、牛津膝关节评分（OKS）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）改善情况以及医学结局研究36项简明健康调查（SF-36）评分。平均随访时间为24个月（范围：12 - 36个月）。
根据SF-36问卷（包含八个不同的生活质量因素）获得的结果，两组之间无显著差异。此外，同期组和分期组的OKS评分分别为39.98±1.52和38.68±2.55。而且，同期组和分期组的WOMAC改善评分分别为84.15±2.2和83.26±2.6。最终膝关节ROM可接受，两组之间无显著差异。
关于并发症、功能和临床结局的大量争议对外科医生进行双侧序贯TKA的决策产生了负面影响。这项临床评估表明，包括OKS、WOMAC、SF-36、ROM、术后出血和住院时间在内的所有决定因素在两组中均表现出几乎相同的改善。根据本研究，两种手术方法在统计学上均无显著差异。
