Al-Yami Ali, Althaqafi Raad M, Al-Yami Al-Waleed, Salman Israa, Albar Hussain, Ramadan Iman, Khalifa Ahmed
King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Department of Surgery, Ministry of the National Guard-Health Affairs, Jeddah, Saudi Arabia.
Eur J Orthop Surg Traumatol. 2025 Jun 16;35(1):249. doi: 10.1007/s00590-025-04360-y.
Patients presenting with bilateral knee disease could undergo unilateral total knee arthroplasty (UTKA) or simultaneous bilateral TKA (SBTKA); however, the safety profile between the two procedures remains controversial; furthermore, data from our population is scarce. So, the current study objective was to report the incidence of 90-day complications comparing UTKA to SBTKA in a Saudi population.
In this retrospective cohort study, we reviewed the medical records from a single institution over ten years, where 1, 046 patients who underwent TKA were identified, of whom 904 fulfilled inclusion criteria, resulting in 514 UTKA and 390 SBTKA. Perioperative and 90-day postoperative morbidity and mortality data were collected.
There were no significant differences in basic demographic characteristics (age, sex, or BMI) or medical comorbidities (including ASA score) between groups. There were no differences between groups regarding length of hospital stay (LOS), p = 0.43. Patients in the SBTKA group had a higher blood transfusion rate, 25.9 vs. 15.8%, respectively, p = 0.001. The overall individual complication incidents were 8.6 and 10.8% for the UTKA and SBTKA groups, respectively. There was no significant difference regarding infection, 2.4 and 2.1% for UTKA and SBTKA groups, respectively, p = 0.52. However, patients in SBTKA had a significantly higher incidence of deep venous thrombosis compared to UTKA patients, 3.3 vs. 1.8%, respectively, p < 0.05. Furthermore, no differences were found regarding gastrointestinal bleeding, pulmonary embolism, cardiovascular, and central nervous system complications. The overall 90-day mortality incidence was 1% (nine patients), and there was no difference between groups, 0.8 vs. 1.3% for the UTKA and SBTKA, respectively, p = 0.56.
Although patients who underwent SBTKA had a higher incidence of blood transfusion and DVT compared to those who underwent UTKA, other complications (including infection) and mortality rates within 90 days were not different. We considered the SBTKA procedure relatively safe in our population; however, longer follow-up is warranted.
患有双侧膝关节疾病的患者可接受单侧全膝关节置换术（UTKA）或同期双侧全膝关节置换术（SBTKA）；然而，这两种手术的安全性仍存在争议；此外，我们人群的数据很少。因此，本研究的目的是报告沙特人群中UTKA与SBTKA相比90天并发症的发生率。
在这项回顾性队列研究中，我们回顾了一家机构十年间的病历，确定了1046例行全膝关节置换术的患者，其中904例符合纳入标准，最终有514例行UTKA，390例行SBTKA。收集围手术期和术后90天的发病率和死亡率数据。
两组之间在基本人口统计学特征（年龄、性别或体重指数）或合并症（包括美国麻醉医师协会评分）方面无显著差异。两组之间的住院时间（LOS）无差异，p = 0.43。SBTKA组患者的输血率较高，分别为25.9%和15.8%，p = 0.001。UTKA组和SBTKA组的总体个体并发症发生率分别为8.6%和10.8%。感染方面无显著差异，UTKA组和SBTKA组分别为2.4%和2.1%，p = 0.52。然而，与UTKA患者相比，SBTKA患者深静脉血栓形成的发生率显著更高，分别为3.3%和1.8%，p < 0.05。此外，在胃肠道出血、肺栓塞、心血管和中枢神经系统并发症方面未发现差异。总体90天死亡率为1%（9例患者），两组之间无差异，UTKA组和SBTKA组分别为0.8%和1.3%，p = 0.56。
尽管与接受UTKA的患者相比，接受SBTKA的患者输血和深静脉血栓形成的发生率较高，但其他并发症（包括感染）和90天内的死亡率并无差异。我们认为在我们的人群中SBTKA手术相对安全；然而，需要更长时间的随访。
