IJCRR - 5(7), April, 2013
SAFETY OF BILATERAL SINGLE STAGE TOTAL KNEE REPLACEMENT UNDER ONE ANAESTHESIA IN TERMS OF PERIOPERATIVE COMPLICATIONS
Author: Shekar M., Chandrasekar C., Sharan Patil
Total knee arthroplasty is now the most common joint replacement procedure performed worldwide and many patients require bilateral replacement. Total knee arthroplasty can provide reliable pain relief and correction of limb alignment in patients with moderate or severe arthritis. It follows that when both knees are affected by the end stage arthritis, replacement of one of the two does not fully restore function and the patient remains significantly debilitated. The surgeon and patient are then faced with the decision of whether to proceed with a staged bilateral total knee replacement, done as two unilateral procedures performed on different days, or a single stage procedure on the same day. Our aim was to assess the safety of single stage bilateral total knee arthroplasty under one anesthetic in terms of perioperative morbidity and mortality and the clinical outcome of the procedure.Fifty patients with 100 knees were studied prospectively from the time of admission to final follow up at SPARSH Hospital, Bangalore, between July 2006 to December 2008.The average postoperative knee score at 6 th month follow up was 86.4, which has a statistical significance in terms of functional outcome . Bilateral single stage procedure has definite advantages of reducing the hospital stay and early rehabilitation of the patients suffering from severe bilateral knee arthritis.
Keywords: Bilateral, total knee arthroplasty, complications
Shekar M., Chandrasekar C., Sharan Patil. SAFETY OF BILATERAL SINGLE STAGE TOTAL KNEE REPLACEMENT UNDER ONE ANAESTHESIA IN TERMS OF PERIOPERATIVE COMPLICATIONS International Journal of Current Research and Review. 5(7), April, 103-111
1. Minter JE, Dorr LD. Indications for bilateral total knee replacement. Contemp Orthop 1995; 31: 108 111.
2. Daniel P. Bullock et al. comparision of simultaneous bilateral with unilateral total knee arthroplasty in terms of perioperative complications. J Bone Joint Surg 2003 Oct; 85 A (10): 1981 1986.
3. Camilo Restrepo et al. Safety of simultaneous bilateral total knee arthroplasty A meta analysis. J Bone Joint Surg Am 2007 Jun; 89: 1220 1226.
4. Ayers, David C et al. Common complications of total knee arthroplasty. J Bone Joint Surg Am 1997 Feb; 79 A (2): 278 311.
5. Insall JN, Dorr LD et al. Rationale of the knee society clinical rating system. Clin Orthop 1989; 309: 102 109.
6. Daniel A. Oakes et al. Bilateral total knee replacement using the same anesthetic is not justified by assessment of the risks. Clin Orthop 2004 November; 428: 87 91.
7. Lombardi AV et al. Simultaneous bilateral total knee arthroplasty: Who decides? Clin.Orthop 2001; 392: 319 329. 8. Vito Pavone et al. Perioperative morbidity in bilateral one stage total knee replacements. Clin Orthop 2004 April; 421: 155 161.
9. National Center for Health Statistics. U. S. decennial life tables for 1989 91. Hyattsville: US Department of health and Human services; 1997: 98 1150.
10. Lynch, Nancy M. Trousdale, Robert T. Ilstrup, Duane M. Mayo Clinic Proceedings, 1997 Sept; 72(9): 799 805.
11. George T. Kolettis et al. Safety of 1 stage bilateral total knee arthroplasty. Clin Orthop 1994; 309: 102 109.
12. Dorr LD et al. Fat emboli in bilateral total knee arthroplasty: Predicting factors for neurologic manifestations. Clin Orthop 1989; 248: 112 118.
13. Michael Soudry et al. Succesive bilateral total knee replacement. J Bone Joint Surg 1985 Apr; 67 A (4): 573 576.
14. Ernest L. Gradillas et al. Bilateral total knee replacement under one anesthetic. Clin Orthop 1979May; 140: 153 158.
15. Worland RL et al. Simultaneous bilateral total knee replacement versus unilateral replacement. Am J Orthop 1996; 25: 292 295.
16. Lane et al. Simultaneous bilateral versus unilateral total knee arthroplasty: Outcomes analysis. Clin Orthop 1997; 345: 106 112.