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The Archives of Bone and Joint Surgery، جلد ۱۲، شماره ۳، صفحات ۱۸۳-۱۹۰
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عنوان انگلیسی The Ideal Timing of Bilateral Total Knee Arthroplasty: Simultaneous Versus Staged
چکیده انگلیسی مقاله Objectives: The ideal timing for patients undergoing bilateral total knee arthroplasty (TKA) remains unknown. The purpose of this study was to compare 90-day outcomes between unilateral, simultaneous bilateral, and staged bilateral TKA.Methods: The PearlDiver database was used to retrospectively identify 231,119 patients undergoing primary TKA during 2015-2020, of which 67,956 (29.4%) were bilateral. Bilateral TKA patients were divided into cohorts of simultaneous bilateral TKA and staged bilateral TKA at 1-14 days, 15-30 days, 31-90 days, and 91-365 days. Each bilateral TKA cohort underwent one-to-one matching with unilateral TKA patients based on age, gender, year, Elixhauser Comorbidity Index (ECI), and a history of obesity, diabetes, and tobacco use. Ninety-day outcomes werecompared between matched groups via univariate and multivariate analysis. In staged bilateral TKA groups, outcomes were collected beginning after the second TKA.Results: Compared to unilateral TKA, simultaneous bilateral TKA was associated with higher rates of venous thromboembolism (VTE; odds ratio [OR] 1.28, 95% confidence interval [CI] 1.07-1.54, p=0.007), acute kidney injury (AKI; OR 1.47, CI 1.17-1.84, p=0.001), blood transfusion (OR 6.81, CI 5.43-8.65, p<0.001), and any complication (OR 1.63, CI 1.49-1.78, p<0.001). Staged bilateral TKA at any time interval studied was associated with a similar or decreased risk of individual complications, emergency department visits, readmissions, reoperations, and any complication relative to unilateral TKA.Conclusion: Simultaneous bilateral TKA is associated with an increased risk of adverse events compared to unilateral TKA. However, bilateral TKA staged at a short interval appears safe in appropriately selected patients. Level of evidence: III
کلیدواژه‌های انگلیسی مقاله Complications, knee arthritis, outcomes, Timing, Total knee arthroplasty
نویسندگان مقاله | Joseph Serino
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA


| E. Terhune
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA


| Robert Burnett
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA


| John Higgins
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA


| Joshua Jacobs
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA


| Craig Della Valle
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA


| Denis Nam
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
نشانی اینترنتی https://abjs.mums.ac.ir/article_23751.html
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زبان مقاله منتشر شده en
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نوع مقاله منتشر شده RESEARCH PAPER
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