Comparison of Simultaneous Bilateral Versus Unilateral Total Knee Replacement on Pain Levels and Functional Recovery

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2020 Apr 16

PMID 32293398

Citations 12

Authors

Ahmad H Alghadir

Zaheen A Iqbal

Shahnawaz Anwer

Dilshad Anwar

Affiliations

Soon will be listed here.

Abstract

Background: Total knee replacement is a common operative procedure to improve pain, function, and quality of life in patients with end stage knee osteoarthritis. The current study aimed to compare simultaneous bilateral versus unilateral total knee replacement on pain intensity and recovery of function.

Methods: A total of 80 patients (bilateral 50, unilateral 30) aged 63.28 (9.4) years undergone total knee replacement participated in the current study. The participants were admitted for 5-7 days in the hospital. Participants in both the group received similar inpatient and outpatient physiotherapy sessions. Pain intensity and function capacity were assessed at baseline, day 7, and day 30 postoperatively using visual analogue scale and lower extremity functional scale, respectively. Repeated measures analysis of variance was used to analyze the data.

Results: Both groups showed a significant reduction of pain intensity (Day 0, mean 8.9, SD 1.0; Day 30, mean 2.2, SD 1.3 in bilateral total knee replacement; Day 0, mean 8.8, SD 1.1; Day 30, mean 2.0, SD 1.5 in unilateral total knee replacement; p < 0.001) and improvement in the functional capacity (Day 0, mean 16.2, SD 10.1; Day 30, mean 55.6, SD 14.6 in bilateral total knee replacement; Day 0, mean 19.1, SD 9.1; Day 30, mean 56.7, SD 15.8 in unilateral total knee replacement; p < 0.001) following total knee replacement at 30 days post-operatively. However, there was a non-significant difference noted between bilateral versus unilateral total knee replacement on the reduction of pain intensity (mean changes, 6.9 versus 6.8) and improvement in the functional capacity (mean changes, 39.4 versus 37.6) at 30 days post-operatively (p > 0.05).

Conclusion: Simultaneous bilateral total knee replacement was associated with a similar reduction of pain intensity and recovery of function compared to unilateral total knee replacement, suggesting the use of simultaneous bilateral total knee replacement in patients with bilateral knee osteoarthritis since its costs and rehabilitation process could be reduced compared to staged bilateral total knee replacement.

Citing Articles

Comparative study of simultaneous and staged bilateral total knee arthroplasty: is age a key factor in surgical outcomes?.

Yalin M, Yildiz H, Kaya M, Golgelioglu F BMC Musculoskelet Disord. 2024; 25(1):892.

PMID: 39516759 PMC: 11546382. DOI: 10.1186/s12891-024-08023-7.

Effect of potential risk factors on renal functions in simultaneous bilateral total knee arthroplasty.

Akar B, Ugur F, Yucel M, Aytug F Front Surg. 2024; 11:1405487.

PMID: 39268493 PMC: 11390695. DOI: 10.3389/fsurg.2024.1405487.

Investigation of Biomechanical Differences in Level Walking between Patients with Bilateral and Unilateral Total Knee Replacements.

Yocum D, Ovispo-Martinez A, Valenzuela K, Wen C, Cates H, Zhang S Bioengineering (Basel). 2024; 11(8).

PMID: 39199721 PMC: 11351753. DOI: 10.3390/bioengineering11080763.

Primary total knee arthroplasty in hemophilic arthropathy.

Beckers G, Masse V, Vendittoli P, Morcos M EFORT Open Rev. 2023; 8(11):830-840.

PMID: 37909693 PMC: 10646519. DOI: 10.1530/EOR-23-0101.

Comparison of time courses in postoperative functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty with propensity score matching.

Oka T, Wada O, Mizuno K Arch Orthop Trauma Surg. 2023; 144(1):369-375.

PMID: 37750909 DOI: 10.1007/s00402-023-05065-9.

References

Jenny J, Trojani C, Prudhon J, Vielpeau C, Saragaglia D, Houillon C . Simultaneous bilateral total knee arthroplasty. A multicenter feasibility study. Orthop Traumatol Surg Res. 2013; 99(2):191-5. DOI: 10.1016/j.otsr.2012.12.015. View

Schafer D . Pulsed lavage in wound cleansing. Phys Ther. 2000; 80(3):292-300. View

Choi Y, Lee H, Ra H, Hwang D, Kim T, Shim S . Perioperative Risk Assessment in Patients Aged 75 Years or Older: Comparison between Bilateral and Unilateral Total Knee Arthroplasty. Knee Surg Relat Res. 2014; 26(4):222-9. PMC: 4258489. DOI: 10.5792/ksrr.2014.26.4.222. View

Jain S, Wasnik S, Mittal A, Sohoni S, Kasture S . Simultaneous bilateral total knee replacement: a prospective study of 150 patients. J Orthop Surg (Hong Kong). 2013; 21(1):19-22. DOI: 10.1177/230949901302100107. View

Reuben J, Meyers S, Cox D, Elliott M, Watson M, Shim S . Cost comparison between bilateral simultaneous, staged, and unilateral total joint arthroplasty. J Arthroplasty. 1998; 13(2):172-9. DOI: 10.1016/s0883-5403(98)90095-x. View

Ekinci Y, Oner M, Karaman I, Kafadar I, Mutlu M, Argun M . Comparison of simultaneous bilateral with unilateral total knee arthroplasty. Acta Orthop Traumatol Turc. 2014; 48(2):127-35. DOI: 10.3944/AOTT.2014.3226. View

Worland R, Johnson G, Alemparte J, Jessup D, Keenan J, Norambuena N . Ten to fourteen year survival and functional analysis of the AGC total knee replacement system. Knee. 2002; 9(2):133-7. DOI: 10.1016/s0968-0160(01)00146-6. View

Yoon H, Han C, Yang I . Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in terms of perioperative complications. J Arthroplasty. 2009; 25(2):179-85. DOI: 10.1016/j.arth.2008.11.103. View

van der Wees P, Wammes J, Akkermans R, Koetsenruijter J, Westert G, Van Kampen A . Patient-reported health outcomes after total hip and knee surgery in a Dutch University Hospital Setting: results of twenty years clinical registry. BMC Musculoskelet Disord. 2017; 18(1):97. PMC: 5335788. DOI: 10.1186/s12891-017-1455-y. View

10.

Mehta S, Fulton A, Quach C, Thistle M, Toledo C, Evans N . Measurement Properties of the Lower Extremity Functional Scale: A Systematic Review. J Orthop Sports Phys Ther. 2016; 46(3):200-16. DOI: 10.2519/jospt.2016.6165. View

11.

Hjermstad M, Fayers P, Haugen D, Caraceni A, Hanks G, Loge J . Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011; 41(6):1073-93. DOI: 10.1016/j.jpainsymman.2010.08.016. View

12.

Thadani P, Vince K, Ortaaslan S, Blackburn D, Cudiamat C . Ten- to 12-year followup of the Insall-Burstein I total knee prosthesis. Clin Orthop Relat Res. 2000; (380):17-29. DOI: 10.1097/00003086-200011000-00004. View

13.

Barrett J, Baron J, Losina E, Wright J, Mahomed N, Katz J . Bilateral total knee replacement: staging and pulmonary embolism. J Bone Joint Surg Am. 2006; 88(10):2146-51. DOI: 10.2106/JBJS.E.01323. View

14.

Zeni Jr J, Snyder-Mackler L . Clinical outcomes after simultaneous bilateral total knee arthroplasty: comparison to unilateral total knee arthroplasty and healthy controls. J Arthroplasty. 2009; 25(4):541-6. PMC: 2876215. DOI: 10.1016/j.arth.2009.02.016. View

15.

Ritter M, Harty L . Debate: simultaneous bilateral knee replacements: the outcomes justify its use. Clin Orthop Relat Res. 2004; (428):84-6. View

16.

de Souza Borges J, Junior P, Dias D, Silva M, Freitas A, Araujo T . Cost and Safety Evaluation of Simultaneous Bilateral Total Knee Arthroplasty versus Unilateral Knee. Rev Bras Ortop (Sao Paulo). 2019; 54(6):709-713. PMC: 6923658. DOI: 10.1055/s-0039-1696682. View

17.

Gill G, Joshi A, Mills D . Total condylar knee arthroplasty. 16- to 21-year results. Clin Orthop Relat Res. 1999; (367):210-5. View

18.

March L, Cross M, Tribe K, Lapsley H, Courtenay B, Cross M . Two knees or not two knees? Patient costs and outcomes following bilateral and unilateral total knee joint replacement surgery for OA. Osteoarthritis Cartilage. 2004; 12(5):400-8. DOI: 10.1016/j.joca.2004.02.002. View

19.

Powell R, Pulido P, Tuason M, Colwell Jr C, Ezzet K . Bilateral vs unilateral total knee arthroplasty: a patient-based comparison of pain levels and recovery of ambulatory skills. J Arthroplasty. 2006; 21(5):642-9. DOI: 10.1016/j.arth.2005.08.009. View

20.

Restrepo C, Parvizi J, Dietrich T, Einhorn T . Safety of simultaneous bilateral total knee arthroplasty. A meta-analysis. J Bone Joint Surg Am. 2007; 89(6):1220-6. DOI: 10.2106/JBJS.F.01353. View