Investigación clínica sobre pie y tobillo

Abstracto

Assessment of Efficacy of Bilateral Total Knee Arthroplasty in Single Sitting

EL Mehdi Sabri, RA Bassir, M Bouffetal, M Kharmaz, MO Lamrani, MS Berrada

Background: A large number of patients with severe end-stage degenerative joint disease have symptomatic bilateral knee joint affliction, necessitating bilateral knee joint replacement.

Aim: To assess clinical and functional efficacy of bilateral total knee arthroplasty in single sitting.

Material and methods: This ambispective observational study was carried in tertiary care teaching hospital in Pune city, India. All patients underwent standard preoperative workup including cardiac fitness with 2D ECHO and pre-anaesthetic checkup. Those patients deemed fit to undergo total knee replacement in single sitting were included in the study. Functional outcome was evaluated using the Knee Society Score (KSS) and clinical outcome was evaluated using Knee Society clinical score (KCS). Statistical Analysis: Mean, standard deviation, percentages and proportions were used for descriptive statistics. Pair t test and Kruskal Wallis test were used as test of significance.

Results: 38 women and 14 men (3:1) (mean age, 63 years) underwent Simultaneous bilateral total knee arthroplasty (SBTKA) for both knees, either with diagnosis as Osteoarthritis (83%) or Rheumatoid arthritis (17%) using a posterior stabilized, cemented prosthesis. At the 3 month follow-up, the mean KSS improved from 64 to 78 (p<0.001) and the mean KFS improved from 63 to 79 (p<0.001). The difference between the means’ of pre op KSS and post op KSS was 36.76 (33.3 to 40.21, 95% CI). The difference between the means’ of pre op KFS and post op KFS was 36.24 (33.46 to 39.03, 95% CI). The P value was significant (<0.001) when the pre op and post op Knee Clinical Scores and Knee Functional scores were compared. Conclusion: Simultaneous bilateral total knee arthroplasty (SBTKA) is a good choice for patient and hospital. SBTKA is effective in improving post-operative clinical and functional outcomes. We recommended larger studies as well as comparative studies for more conclusive evidence.