Piovan G, Screpis D, Natali S, Iacono V, Baldini M, Farinelli L, Guerriero M, Zorzi C
IRCCS Ospedale Sacro Cuore-Don Calabria, Viale Luigi Rizzardi 4, Negrar di, Valpolicella (VR), Italy.
Clinica Ortopedica Dell'adulto e Pediatrica, Università Politecnica Delle Marche, Via Tronto 10/A, Ancona (AN), Italy.
Adv Orthop. 2022 Aug 21;2022:1989822. doi: 10.1155/2022/1989822. eCollection 2022.
The aim of this study was to look for preoperative patients' related factors correlating with worse clinical outcomes in a cohort of elderly patients undergoing simultaneous bilateral total knee arthroplasty (SiBTKA) to search for risk factors, which may influence clinical outcomes and safety. . The hospital database was mined searching for patients older than 70 years that underwent SiBTKA for severe bilateral knee osteoarthritis (OA) between 2012 and 2016. Preoperative clinical information, Oxford Knee Score (OKS), and Knee Injury and Osteoarthritis Outcome Score (KOOS) prior to surgery were recorded. The OKS and the KOOS were submitted again after a minimum of 5 years of follow-up (FU).
An improvement was observed in all clinical scores at last FU. The major complication rate was 5.4%. No patients' clinical data showed correlation with perioperative complications or need for transfusions. Functional scores at the last FU were negatively affected by age at surgery and positively affected by preoperative clinical scores. . In the setting of severe symptomatic bilateral knee OA, SiBTKA seems to be effective in improving symptoms at midterm follow-up, with acceptable rates of perioperative complications in patients older than 70. Higher age at surgery and lower preoperative functional scores are associated with worse clinical outcomes at FU. This could assist surgeons in advising patients that delay of surgical treatment could worsen outcomes.
本研究旨在寻找接受同期双侧全膝关节置换术（SiBTKA）的老年患者队列中与较差临床结局相关的术前患者相关因素，以寻找可能影响临床结局和安全性的危险因素。通过挖掘医院数据库，寻找2012年至2016年间因严重双侧膝关节骨关节炎（OA）接受SiBTKA的70岁以上患者。记录术前临床信息、牛津膝关节评分（OKS）以及手术前的膝关节损伤和骨关节炎结局评分（KOOS）。在至少5年的随访（FU）后再次提交OKS和KOOS。
在末次随访时，所有临床评分均有改善。主要并发症发生率为5.4%。没有患者的临床数据显示与围手术期并发症或输血需求相关。末次随访时的功能评分受到手术时年龄的负面影响，并受到术前临床评分的正面影响。在严重症状性双侧膝关节OA的情况下，SiBTKA在中期随访时似乎能有效改善症状，70岁以上患者围手术期并发症发生率可接受。手术时年龄较大和术前功能评分较低与随访时较差的临床结局相关。这可以帮助外科医生向患者建议，手术治疗延迟可能会使结局恶化。
