Clinical Study Of Simultaneous Bilateral Total Knee Arthroplasty

Objective:To investigate the clinical efficacy and safety of simultaneous bilateral total knee arthroplasty in patients with simultaneous bilateral total knee arthroplasty and patients with simultaneous bilateral total knee arthroplasty,we compared them with patients with simultaneous bilateral total knee arthroplasty,including two unilateral ones.Methods:A total of 239 patients diagnosed with knee osteoarthritis and undergoing knee arthroplasty from November 2018 to June 2020 in the Department of Arthritis and Sports Medicine of Qujing Hospital Affiliated to Kunming Medical University were selected.Among the patients with knee arthroplasty,73 patients underwent bilateral total knee arthroplasty during the same period.According to include and exclude standards,at the same time in 41 patients with bilateral knee arthroplasty(group A),patients with unilateral total knee replacement in 63(group B),including eight lines in patients with unilateral total knee replacement(group B1)for patients with bilateral total knee replacement in stages,on one side only for patients with total knee arthroplasty(group B2)of 47 people.Preoperative age structure,gender composition,body mass index(BMI),duration of disease and HSS score of 2 groups were compared,and there were no statistical difference in preoperative data of all patients(P>0.05).The operative time,intraoperative blood loss,postoperative drainage volume,postoperative hemoglobin(Hb)decline,perioperative complications,length of hospital stay,hospitalization cost and HSS score were recorded and analyzed in 2 groups.Results:Deep vein thrombosis(DVT)occurred in 3 patients of group A and 2 patients of group B.All patients were cured and discharged after standard anticoagulant therapy.There are three patients in group A of fat liquefaction of incision,group B there are four patients had the fat liquefaction of incision,two groups of patients after active treatment the wound healed well,two groups of patients without pulmonary embolism,disease of heart head blood-vessel,no postoperative infection and death of patients,two groups of peoples with postoperative complications is no statistical difference(P>0.05);There were 5 patients in group A required blood transfusion and 3 patients in group B required blood transfusion,and there was no statistical difference in blood transfusion rate between the two groups(P>0.05).The average length of hospital stays in group A was(18.59±2.01)days,and the total average length of hospital stays in group B1 was(28.25±1.98)days,which was statistically different from that in group A(P<0.05).The average hospitalization expenses of group A was(80522.18±3973.93)yuan,and the total average hospitalization expenses of group B1 was(87393.22±4421.51)yuan,which was statistically different from that of group A(P<0.05).The HSS score of group A was(89.024 ± 0.962),group B1 was(89.625±1.408)and group B2 was(89.085 ±0.996)at 3 months after surgery.There was no significant difference in HSS score at 3 months after operation(P>0.05).Conclusion(s):Compared with unilateral and staged bilateral total knee arthroplasty,the perioperative blood transfusion rate and postoperative complications were not significantly increased,and the safety was the same.The results of simultaneous bilateral total knee arthroplasty were comparable to those of unilateral total knee arthroplasty and staged bilateral total knee arthroplasty.For patients with bilateral knee osteoarthritis,simultaneous bilateral total knee arthroplasty can save hospitalization cost and shorten hospitalization time compared with staged bilateral total knee arthroplasty.Concurrent bilateral total knee arthroplasty is preferred for patients with bilateral knee osteoarthritis through preoperative...