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Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients. | LitMetric

AI Article Synopsis

  • One-stage bilateral total knee arthroplasty (TKA) was studied in low-risk patients (ASA class 1 or 2) to assess safety and outcomes.
  • The study involved 67 patients where no major complications occurred, although there was significant blood loss (1139.5 ml) and a high transfusion rate (95.5%).
  • Results showed improved postoperative knee extension and clinical scores, suggesting one-stage bilateral TKA can be safe and effective for selected low-risk patients with minimal risk of complications.

Article Abstract

Background: An increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patients.

Methods: Sixty-seven patients who received one-stage bilateral TKAs for osteoarthritis who were American Society of Anesthesiology (ASA) class 1 or 2 were included in this study. Perioperative complications, blood loss, transfusion rate, blood laboratory results, and clinical results were evaluated up to 1 year after surgery.

Results: No major complications (deep infection, pulmonary embolism, cerebrovascular accident, myocardial infarction, death, or removal or revision of the implants) were observed. The average total blood loss was 1139.5 ml. The transfusion rate was 95.5%. Postoperative hemoglobin level and C-reactive protein level gradually improved up to postoperative day 21 (P < 0.01). Bilateral knee extension knee angles and clinical scores improved postoperatively as compared with preoperative values (P < 0.01).

Conclusions: Although total blood loss and transfusion rate can be high, this preliminary case series suggested that the one-stage bilateral TKA in ASA class 1 or 2 patients can have high perioperative safety levels, and good clinical results can be obtained up to 1 year after surgery. If low-risk patients are selected for bilateral TKA, a one-stage procedure can be beneficial for patients, with a minimal increase in the risk of complications.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5772713PMC
http://dx.doi.org/10.1186/s13018-018-0720-6DOI Listing

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