Accatino Giada, Monzio Compagnoni Alessandra, Grassi Federico Alberto, Castelli Alberto, Pasta Gianluigi, Benazzo Francesco, Rossi Stefano Marco Paolo, Jannelli Eugenio
Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University Study of Pavia, 27100 Pavia, Italy.
Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy.
Healthcare (Basel). 2024 Sep 23;12(18):1902. doi: 10.3390/healthcare12181902.
This retrospective study aims to evaluate the safety and functional outcomes of simultaneous bilateral total knee arthroplasty (TKA) compared to two-stage bilateral TKA procedures. Osteoarthritis is the leading cause of knee joint replacement globally, so we sought to determine whether the one-stage approach could be deemed non-inferior to the two-stage method in terms of perioperative complications and postoperative recovery. We analyzed two cohorts: 43 patients underwent one-stage bilateral TKA, while 66 patients received two-stage TKA. The data collected included demographic details, comorbidities, postoperative complications, and functional outcomes assessed by the Oxford Knee Score (OKS), European Quality of Life, and Visual Analogue Scale scores at preoperative and five years postoperative follow-ups. The results showed statistically significant improvements in quality-of-life measures for both groups, with the one-stage group exhibiting greater enhancement in OKS ( < 0.05). Complication rates were similar across both procedures, with no significant differences in infection rates or other adverse events. This study suggests that the one-stage approach to treat bilateral knee arthritis could reduce subjective stress and healthcare costs, presenting a safe alternative for appropriately selected patients. However, the findings highlight the necessity of considering patients' overall health status when planning surgical interventions. Further research involving larger populations is recommended to validate our conclusions.
这项回顾性研究旨在评估同期双侧全膝关节置换术(TKA)与分期双侧TKA手术相比的安全性和功能结果。骨关节炎是全球膝关节置换的主要原因,因此我们试图确定在围手术期并发症和术后恢复方面,一期手术方法是否可被视为不劣于二期手术方法。我们分析了两个队列:43例患者接受了一期双侧TKA,而66例患者接受了分期TKA。收集的数据包括人口统计学细节、合并症、术后并发症以及术前和术后五年随访时通过牛津膝关节评分(OKS)、欧洲生活质量和视觉模拟量表评分评估的功能结果。结果显示两组患者的生活质量指标均有统计学上的显著改善,一期手术组在OKS方面的改善更大(<0.05)。两种手术的并发症发生率相似,感染率或其他不良事件无显著差异。这项研究表明,治疗双侧膝关节炎的一期手术方法可以减轻主观压力并降低医疗成本,为适当选择的患者提供了一种安全的替代方案。然而,研究结果强调了在规划手术干预时考虑患者整体健康状况的必要性。建议进行涉及更多人群的进一步研究以验证我们的结论。