| Objective To evaluate the safety and clinical efficacy of simultaneous bilateral total knee arthroplasty under epidural anesthesia in treatment of osteoarthritis when compared with unilateral total knee arthroplasty.Methods705patients with osteoarthritis of the knee who underwent total knee arthroplasty between May2000and May2009were identified from hospital datebase, which included268simultaneous bilateral total knee arthroplasty and437unilateral total knee arthroplasty. To compare the demographics and preoperative morbidity, peri operative complications, hematologic indicators, and costs of hospitalization and clinical outcome indicators.Results No significantly differences were found with regard to the demographics and preoperative morbidity. The number of post-operative complications was significantly higher in simultaneous bilateral group (15.6%) when compared with the unilateral group (7.8%). The rate of cardiovascular complications was significantly higher in simultaneous bilateral group(7.3%)than in the unilateral group(3.2%).There was no increase in the rate of others post-operative complications such as infection, mortality,pulmonary embolism in simultaneous bilateral group. The simultaneous bilateral procedures had a significantly higher postoperative blood loss and blood transfusion. No significantly differences were found with regard to post-operative Knee society scores (KSS)at2-year follow-up, Knee Society function scores were better in the simultaneous bilateral group.Conclusion It was concluded that simultaneous bilateral total knee arthroplasty under epidural anesthesia may be considered to be lower overall hospital costs, sooner recovery after operation, in Patients with bilateral knee osteoarthritis. Preoperative health condition should be assessed carefully, patients in high-risk, especially with severe cardiovascular disease should avoid simultaneous bilateral total knee arthroplasty. |
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