Long Term Outcomes of Single Staged Sequential Bilateral Total Knee Replacement in Patients Aged 60 Years or Above

Authors

  • Hafeez Ur Rehman Orthopedic Department, Liaquat National Hospital Karachi, Pakistan.
  • Noman Khan Orthopedic Department, Liaquat National Hospital Karachi, Pakistan.
  • Shahid Noor Orthopedic Department, Liaquat National Hospital Karachi, Pakistan.
  • Kazim Rahim Najjad Orthopedic Department, Liaquat National Hospital Karachi, Pakistan
  • Nasir Ahmed Orthopedic Department, Liaquat National Hospital Karachi, Pakistan
  • Sukaina Rupani Department of Surgery, SIUT Civil Hospital Karachi, Pakistan.
  • Khalid Khatir Orthopedic Department, Liaquat National Hospital Karachi, Pakistan.

DOI:

https://doi.org/10.36570/jduhs.2022.2.1605

Abstract

Objective: To determine the long-term outcomes of single staged bilateral total knee arthroplasty in patients of geriatric age group.
Methods: This single-center retrospective study was carried out at Liaquat National Hospital Karachi, Pakistan. Data of 2001 to 2010 were retrieved from the medical records. All geriatric age group patients above 60 years irrespective of comorbidity status, underwent single-stage bilateral total knee arthroplasty were consecutively included. Pre-operative diagnoses such as primary osteoarthritis, post-traumatic arthritis and rheumatoid arthritis were noted. The minimum follow-up time period was 10 years. Long term outcome such as knee society score, adverse event, and need of revision surgery were noted.
Results: Of 96 patients, the median age was 69.0 (65.0-76.0) years. There were 44 (45.8%) males and 52 (54.2%) females. Primary osteoarthritis was the most common primary diagnosis, i.e., 66 (68.8%) followed by rheumatoid arthritis in 24 (25.0%), and post-traumatic arthritis in 6 (6.3%) patients. Most of the patients had moderate Charlson Comorbidity Index score, i.e., 70 (72.9%) while Knee Society Score showed that 41 (40%) reported excellent outcome. Need of revision surgery was reported by 6 (6.3%) patients. Adverse events were reported by 11 (11.5%) patients. A significant median difference of Knee Society Score was found among patients with diabetes mellitus (p-value <0.001) and pre-operative diagnosis (p-value <0.001).
Conclusion: The long-term outcome of patients underwent bilateral total knee arthroplasty was found satisfactory. It is likely that total knee arthroplasty is widely regarded as the best option for treating end-stage knee osteoarthritis.

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References

Primorac D, Molnar V, Rod E, Jelec Z, Cukelj F, Matisic V, et al. Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations. Genes (Basel) 2020; 11:854. doi: 10.3390/genes11080854

Eckstein F, Wirth W, Culvenor AG. Osteoarthritis year in review 2020: imaging. Osteoarthritis Cartilage 2021; 29:170-9. doi: 10.1016/j.joca.2020.12.019

Rodriguez - Merchan EC. Patient dissatisfaction after total knee arthroplasty for hemophilic arthropathy and osteoarthritis (non-hemophilia patients). Expert Rev Hematol 2016; 9:59-68. doi: 10.1586/17474086.2016.1112263

Stromer W, Pabinger I, Ay C, Crevenna R, Donne-rer J, Feistritzer C, et al. Pain management in hemophilia: expert recommendations. Wien Klin Wochenschr 2021; 133):1042-56. doi: 10.1007/s00508-020-01798-4

Kandarian BS, Elkassabany NM, Tamboli M, Mar-iano ER. Updates on multimodal analgesia and regional anesthesia for total knee arthroplasty patients. Best Pract Res Clin Anaesthesiol 2019; 33: 111-23. doi: 10.1016/j.bpa.2019.02.004

Yong TM, Young EC, Molloy IB, Fisher BM, Keeney BJ, Moschetti WE. Long-Term Implant Survivorship and Modes of Failure in Simultaneous Concurrent Bilateral Total Knee Arthroplasty. J Arthroplasty 2020; 35:139-44. doi: 10.1016/j.arth.2019.08.011

Liu L, Liu H, Zhang H, Song J, Zhang L. Bilateral total knee arthroplasty: Simultaneous or staged? A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e15931. doi: 10.1097/MD.0000000000015931

Sheth DS, Cafri G, Paxtn EW, Namba RS. Bilateral Simultaneous vs Staged Total Knee Arthroplasty: A Comparison of Complications and Mortality. J Arthroplasty 2016; 31:212-6. doi: 10.1016/j.arth.2016.03.018

Marya SK, Amit P, Singh C. Impact of Charlson indices and comorbid conditions on complication risk in bilateral simultaneous total knee arthroplasty. Knee 2016; 23:955-9. doi: 10.1016/j.knee.2016.05.013

Amit P, Marya SKS. Age-adjusted Charlson comrbidity index as a novel guideline for patient selection between unilateral versus bilateral simultaneous total knee arthroplasty. Arch Orthop Trauma Surg 2021; 142:657-63. doi: 10.1007/s00402-021-03841-z

Passias PG, Bono OJ, Bono JV. Total Knee Arthroplasty in Patients of Advanced Age: A Look at Outcomes and Complications. J Knee Surg 2020; 33:1-7. doi: 10.1055/s-0038-1676067

Gao J, Xing D, Dong S, Lin J. The primary total knee arthroplasty: a global analysis. J Orthop Surg Res 2020; 15:190.

doi: 10.1186/s13018-020-01707-5

Onggo JR, Onggo JD, De Steiger R, Hau R. Roboticassisted total knee arthroplasty is comparable to conventional total knee arthroplasty: a meta-analysis and systematic review. Arch Orthop Trauma Surg 2020; 140:1533-49. doi: 10.1007/s00402-020-03512-5

Gabr A, Withers D, Pope J, Santini A. Functional outcome of staged bilateral knee replacements. Ann R Coll Surg Engl 2011; 93:537-41. doi: 10.1308/147870811X13137608454803

Kundu IK, Chowdhury AZ, Faisal A, Arefin KN, Rahman MN, Paul MS, et al. Functional outcome of bilateral total knee replacement in advanced osteoarthritis in simultaneous versus staged procedure. Mymensingh Med J. 2022 Jan;31(1):165-171.

Paxton E, Inacio M, Slipchenko T, Fithian D. The Kaiser Permanente national total joint replacement registry. Perm J 2008; 12:12–6.

doi:10.7812/tpp/08-008

Trojani C, Bugnas B, Blay M, Carles M, Boileau P. Bilateral total knee arthroplasty in a one-stage surgical procedure. Orthop Traumatol Surg Res 2012; 98:857- 62. doi: 10.1016/j.otsr.2012.08.003

Meftah M, Ranawat AS, Sood AB, Rodriguez JA, Ranawat CS. All-polyethylene tibial implant in young active patients a concise follow-up, 10 to 18 years. J Arthroplasty 2012; 27:10–4.

Dong S, Zhao Y, Li JJ, Xing D. Global research tre-nds in revision total knee arthroplasty: A bibliometric and visualized study. Indian J Orthop 2021; 55:1335-47. doi: 10.1007/s43465-021-00390-w

Chen T, Zhu J, Zhao Y, Li H, Li P, Fan J, et al. The global state of research in pain management of osteoarthritis (2000-2019): A 20-year visualized analysis. Medicine (Baltimore) 2021; 100:e23944. doi: 10.1097/MD.0000000000023944

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Published

2022-07-04

How to Cite

Ur Rehman, H., Khan, N. ., Noor, . S. ., Rahim Najjad, K. ., Ahmed, N. ., Rupani, S. ., & Khatir, K. . (2022). Long Term Outcomes of Single Staged Sequential Bilateral Total Knee Replacement in Patients Aged 60 Years or Above. Journal of the Dow University of Health Sciences (JDUHS), 16(2), 83–88. https://doi.org/10.36570/jduhs.2022.2.1605

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Original Articles