Simultaneous bilateral total knee arthroplasty is safe and effective for patients in different ages

J Orthop Sci. 2023 Jan;28(1):173-179. doi: 10.1016/j.jos.2021.08.011. Epub 2021 Oct 9.

Abstract

Background: Simultaneous bilateral total knee arthroplasty is considered beneficial for patients with bilateral end-stage knee osteoarthritis, even though there could be potential postoperative complications. Presently, there is a paucity of evidence of the efficacy and safety of SB-TKA for elderly patients. This study aimed to compare the clinical outcomes of simultaneous bilateral total knee arthroplasty by different age groups.

Methods: A total of 216 knees of 108 patients, who underwent simultaneous bilateral total knee arthroplasty for osteoarthritis at our hospital between April 2015 and September 2018, were divided into three groups based on age: 60s (44 knees), 70s (106 knees), and 80s (66 knees). Perioperative data and postoperative clinical outcomes 1 year after surgery were compared between the age groups.

Results: The patients in the Group 60s were characterized by a higher body mass index (BMI) (P < 0.01), a lower pre-operative knee function score (P < 0.01), longer operation time (P < 0.01), greater intra-operative (P < 0.01), and postoperative bleeding (P = 0.026). No significant difference was found in terms of occurrence of various postoperative complications, although deep vein thrombosis and delirium occurred slightly more frequently in the Group 70s and the Group 80s than in the Group 60s group. The Knee Society Knee Score, a function score, and patient satisfaction scores were significantly improved in all groups 1 year after surgery. Moreover, these indexes of clinical outcomes were similar among the three groups.

Conclusion: Performing simultaneous bilateral total knee arthroplasty in 80s patients was found to be as safe and effective as in the 60s and 70s patients.

Level of evidence: 3 (A retrospective cohort study).

Keywords: Age groups; Clinical outcomes; Complications; Simultaneous bilateral total knee arthroplasty (SB-TKA).

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Humans
  • Knee Joint / surgery
  • Middle Aged
  • Osteoarthritis, Knee* / diagnostic imaging
  • Osteoarthritis, Knee* / etiology
  • Osteoarthritis, Knee* / surgery
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome