Clinical Analysis Of Simultaneous And Staged Bilateral Total Knee Arthroplasty

ObjectiveTo assess the efficacy of knee joint disease with the treatment of total kneearthroplasty in different time Compared the general information, preoperativecomorbidities, early postoperative complications, bilateral surgery total drainage volume,the total volume of blood transfusion, the total cost of hospitalization and knee functionrecovery indicators of the patients with simultaneous Bilateral total kneearthroPlasty(BTKA) and staged bilateral total knee arthroplasty(BTKA) to research thedifferences between them. To indicate the advantages and disadvantages and efficacy ofbilateral total knee arthroplasty with a better guide to clinical practice.MethodsAccording to the clinical data of TengZhou Center People’s Hospital, weretrospectively analyzed of the data of45patients of knee joint disease with the treatmentof total knee arthroplasty from2009.1to2011.9. They all had integral follow-up data.Depending on whether they had simultaneous bilateral total knee arthroplasty, they weredivided into groups A, B, A group for the patients with bilateral total knee arthroplasty inthe same time, B group for the patients with bilateral total knee arthroplasty in the differenttime (interval time of surgery is3to10months). The two groups of patients with primarydisease were severe degenerative joint disease of the knee, They were performed of totalknee arthroplasty with posterior stabilized prosthesis. Compared the general Information,preoperative comorbidities, early postoperative complications, bilateral surgery totaldrainage volume, the total volume of blood transfusion, the total cost of hospitalization andknee function ecovery indicators of the patients with simultaneous BTKA and stagedBTKA to research the differences between them.ResultsThere were no statistically significant between two groups in the sex ratio,age and body mass index. The proportion of the patients in B group with one or several medicalcomorbidities was higher than the proportion of the patients in A group before operation.The appeared rates of early postoperative complication in group with simultaneous BTKAwas higher than in group with staged BTKA. The most apperred complication wascardiovascular complications, thrombosis and spiritual aspects complications.The infectionaround joint were not appeared in all cases.And no patient was dead until the follow-uptime was over. There was statistical significante difference between the group withsimultaneous BTKA and the group with staged BTKA in total lead flow, total amount ofblood transfusion (P<0.05). the total cost of patients in the group with simultaneousBTKA reduced by22.9%.After follow-up six months, there was no statistical significantdifference in HSS score of knee joint function between two groups.(P>0.05).ConclusionThe totol knee arthroplasty is the effective treatment of severe knee degenerativeosteoarthropathy and the clinical curative effect is distinct. The right choosing of the wayof TKA (Total Knee Arthroplasty) is very important to the treatment and rehabilitation ofknee osseous arthritis. Through the comparision between two groups in early postoperativecomplications, double side operation lead flow, total blood transfusions, totalhospitalization expense and the recovery of knee joint function,it is appeared the less cost,shorter hospitalization time and recovery time in group with simultaneous BTKA.And thefunction of double lower limbs improved in group with simultaneous BTKA.Sosimultaneous BTKA is a kind of economic and effective treatment method.But it isapperred bigger surgery trauma,increased operation difficulty,more amount of bleedingand longer anesthesia time in group with simultaneous BTKA。And early postoperativecomplication rate is higher and the risk increased in group with simultaneous BTKA.But itdoes not effect the end function of knee. The detailed body condition of patient need to beevaluated before operation. Simultaneous BTKA is avoid to be operated on the patient withold age, poor general body condition and serious complications, especially cardiovascularsystem diseases.The right choose of the time of operation can effectively reduce theapperation of complications.It is one of the factors to successfully cure severe kneedegenerative osteoarthropath.