Gali Julio Cesar, Brotto Anna Flavia de Crescenzo, de Mello Danilo Pássaro Pires, Mauad Juliana Ribeiro, Gali Filho Julio Cesar
Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas e da Saúde de Sorocaba, Pontifícia Universidade Católica de São Paulo, Sorocaba, SP, Brasil.
Núcleo de Ortopedia e Traumatologia do Esporte, Sorocaba, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2022 Oct 3;58(3):428-434. doi: 10.1055/s-0042-1756152. eCollection 2023 Jun.
This study aims to analyze the safety of a simultaneous bilateral total knee arthroplasty (SBTKA) and to investigate patients' satisfaction with the procedure performed concomitantly. In a prospective study, we evaluated 45 patients undergoing SBTKA performed by two surgical teams. The mean age of the patients was 66.9 years; 33 subjects were female (73.3%) and 12 (26.6%) were male. We followed a protocol of intra- and postoperatively measures to ensure the safety of this procedure. We evaluated the surgery time and blood loss by hematocrit (Ht) and hemoglobin (Hb) levels on the first postoperative day, the percentage of patients who received a transfusion of packed red blood cells, and the number of required units. We also recorded perioperative complications, and, at the end of 3 months, we asked patients about their preference between the simultaneous or staged procedure. The mean surgery time was 169 minutes. In the postoperative period, there was an average decrease of 28.2% in Htc and 27.0% in Hgb. A total of 16 patients (35.5%) received a transfusion of packed red blood cells (mean, 1.75 units per patient requiring a transfusion). There were 12 minor complications (26.6%) and 2 major complications (4.4%); furthermore, no patient had a clinical diagnosis of deep vein thrombosis, and there were no deaths. The SBTKA procedure may be considered safe if performed in selected patients and with a care protocol to prevent complications. This type of procedure was unanimously approved by patients.
本研究旨在分析同期双侧全膝关节置换术（SBTKA）的安全性，并调查患者对同期进行该手术的满意度。在一项前瞻性研究中，我们评估了由两个手术团队进行SBTKA的45例患者。患者的平均年龄为66.9岁；33例为女性（73.3%），12例为男性（26.6%）。我们遵循了一套术中和术后措施方案以确保该手术的安全性。我们通过术后第一天的血细胞比容（Ht）和血红蛋白（Hb）水平评估手术时间和失血量、接受浓缩红细胞输血的患者百分比以及所需的单位数。我们还记录了围手术期并发症，并且在3个月末，我们询问患者对于同期或分期手术的偏好。平均手术时间为169分钟。术后，Htc平均下降28.2%，Hgb平均下降27.0%。共有16例患者（35.5%）接受了浓缩红细胞输血（平均每位需要输血的患者为1.75单位）。有12例轻微并发症（26.6%）和2例严重并发症（4.4%）；此外，没有患者有深静脉血栓形成的临床诊断，也没有死亡病例。如果在选定的患者中进行并采用预防并发症的护理方案，SBTKA手术可被认为是安全的。这种手术方式得到了患者的一致认可。
