Bilateral simultaneous total knee arthroplasty in severely deformed knees: use of an evidence-based rehabilitation programme

Original Article

Abstract

Post-operative rehabilitation after staged total knee arthroplastiess (TKAs) in severely deformed bilateral knee disease can be a very difficult task. At the same time, the safety of simultaneous (one stage) bilateral TKA remains controversial and highly debatable. We wish to report our experience with simultaneous bilateral conventional TKAs for all severely deformed knees, followed by a carefully planned, evidence-based rehabilitation programme. Simultaneous bilateral TKA in severely deformed knees is safe and very effective, provided attention to details of rehabilitation and overall multidisciplinary medical care is exercised.

Keywords

Simultaneous bilateral knee arthroplasty Severe deformity of knees Rehabilitation Complications Post-operative protocol 

References

  1. 1.
    Patil N, Wakankar H (2008) Morbidity and mortality of simultaneous bilateral total knee arthroplasty. Orthopaedics 31(8). pii: orthosupersite.com/view.asp?rID = 30509Google Scholar
  2. 2.
    Restrepo C, Parvizi J, Dietrich T, Einhorn TA (2007) Safety of simultaneous bilateral total knee arthroplasty. A meta-analysis. J Bone Joint Surg Am 89(6):1220–1226CrossRefPubMedGoogle Scholar
  3. 3.
    Leitch KK, Dalgorf D, Borkhoff CM, Kreder HJ (2005) Bilateral total knee arthroplasty—staged or simultaneous? Ontario’s orthopaedic surgeons reply. Can J Surg 48(4):273–276PubMedGoogle Scholar
  4. 4.
    Ivory JP, Simpson AH, Toogood GJ, McLardy-Smith PD, Goodfellow JW (1993) Bilateral knee arthroplastys: simultaneous or staged? J R Coll Surg Edinb 38(2):105–107PubMedGoogle Scholar
  5. 5.
    Dennis DA (2004) Debate: bilateral simultaneous total knee arthroplasty. Clin Orthop Relat Res 428:82–83CrossRefPubMedGoogle Scholar
  6. 6.
    Bullock DP, Sporer SM, Shirreffs TG Jr (2003) Comparison of simultaneous bilateral with unilateral total knee arthroplasty in terms of peri-operative complications. J Bone Joint Surg Am 85-A(10):1981–1986PubMedGoogle Scholar
  7. 7.
    Reuben JD, Meyers SJ, Cox DD, Elliott M, Watson M, Shim SD (1998) Cost comparison between bilateral simultaneous, staged, and unilateral total joint arthroplasty. J Arthroplasty 13(2):172–179CrossRefPubMedGoogle Scholar
  8. 8.
    Ritter MA, Harty LD (2004) Simultaneous bilateral knee arthroplastys: the outcomes justify its use. Clin Orthop Relat Res 428:84–86CrossRefPubMedGoogle Scholar
  9. 9.
    Ritter MA, Harty LD, Davis KE, Meding JB, Berend M (2003) Simultaneous bilateral, staged bilateral, and unilateral total knee arthroplasty. A survival analysis. J Bone Joint Surg Am 85-A(8):1532–1537PubMedGoogle Scholar
  10. 10.
    Brotherton SL, Roberson JR, de Andrade JR, Fleming LL (1986) Staged versus simultaneous bilateral total knee arthroplasty. J Arthroplasty 1(4):221–228CrossRefPubMedGoogle Scholar
  11. 11.
    Pavone V, Johnson T, Saulog PS, Sculco TP, Bottner F (2004) Peri-operative morbidity in bilateral one-stage total knee arthroplastys. Clin Orthop Relat Res 421:16–155CrossRefGoogle Scholar
  12. 12.
    Huotari K, Lyytikäinen O, Seitsalo S (2007) Hospital infection surveillance team. Patient outcomes after simultaneous bilateral total hip and knee joint arthroplastys. J Hosp Infect 65(3):219–225 (Epub 2007 Feb 2)CrossRefPubMedGoogle Scholar
  13. 13.
    Lane GJ, Hozack WJ, Shah S, Rothman RH, Booth RE Jr, Eng K, Smith P (1997) Simultaneous bilateral versus unilateral total knee arthroplasty. Outcomes analysis. Clin Orthop Relat Res 345:106–112CrossRefPubMedGoogle Scholar
  14. 14.
    Ritter MA, Meding JB (1987) Bilateral simultaneous total knee arthroplasty. J Arthroplasty 2(3):185–189CrossRefPubMedGoogle Scholar
  15. 15.
    Hersekli MA, Akpinar S, Ozalay M, Ozkoç G, Uysal M, Cesur N, Tandoğan RN (2004) A comparison between single- and two-staged bilateral total knee arthroplasty operations in terms of the amount of blood loss and transfusion, peri-operative complications, hospital stay, and cost-effectiveness. Acta Orthop Traumatol Turc 38(4):241–246PubMedGoogle Scholar
  16. 16.
    Husted H, Blønd L, Sonne-Holm S, Holm G, Jacobsen TW, Gebuhr P (2003) Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients. Acta Orthop Scand 74(6):665–669CrossRefPubMedGoogle Scholar
  17. 17.
    Choi WS, Irwin MG, Samman N (2009) The effect of tranexamic acid on blood loss during orthognathic surgery: a randomized controlled trial. J Oral Maxillofac Surg 67(1):125–133CrossRefPubMedGoogle Scholar
  18. 18.
    Elwatidy S, Jamjoom Z, Elgamal E, Zakaria A, Turkistani A, El-Dawlatly A (2008) Efficacy and safety of prophylactic large dose of tranexamic acid in spine surgery: a prospective, randomized, double-blind, placebo-controlled study. Spine 33(24):2577–2580CrossRefPubMedGoogle Scholar
  19. 19.
    Hynes MC, Calder P, Rosenfeld P, Scott G (2005) The use of tranexamic acid to reduce blood loss during total hip arthroplasty: an observational study. Ann R Coll Surg Engl 87(2):99–101CrossRefPubMedGoogle Scholar
  20. 20.
    Veien M, Sørensen JV, Madsen F, Juelsgaard P (2002) Tranexamic acid given intraoperatively reduces blood loss after total knee arthroplasty: a randomized, controlled study. Acta Anaesthesiol Scand 46(10):1206–1211CrossRefPubMedGoogle Scholar
  21. 21.
    Callaghan JJ, Warth LC, Hoballah JJ, Liu SS, Wells CW (2008) Evaluation of deep venous thrombosis prophylaxis in low-risk patients undergoing total knee arthroplasty. J Arthroplasty 23:20–24CrossRefPubMedGoogle Scholar
  22. 22.
    Stausholm K, Rosenberg-Adamsen S, Skriver M, Kehlet H, Rosenberg J (1995) Comparison of three devices for oxygen administration in the late post-operative period. Br J Anaesth 74(5):607–609CrossRefPubMedGoogle Scholar
  23. 23.
    Moore JN, Garner HE, Johnson JH, Huesgen JG (1978) Continuous administration of oxygen during the immediate postanesthetic period. Vet Med Small Anim Clin 73(11):1397–1398PubMedGoogle Scholar
  24. 24.
    Jones JG, Jordan C, Scudder C, Rocke DA, Barrowcliffe M (1985) Episodic post-operative oxygen desaturation: the value of added oxygen. J R Soc Med 78(12):1019–1022PubMedGoogle Scholar
  25. 25.
    Patel VP, Walsh M, Sehgal B, Preston C, DeWal H, Di Cesare PE (2007) Factors associated with prolonged wound drainage after primary total hip and knee arthroplasty. J Bone Joint Surg Am 89(1):33–38CrossRefPubMedGoogle Scholar
  26. 26.
    Leone JM, Hanssen AD (2006) Management of infection at the site of a total knee arthroplasty. Instr Course Lect 55:449–461PubMedGoogle Scholar
  27. 27.
    Ravenscroft MJ, Harker J, Buch KA (2006) A prospective, randomised, controlled trial comparing wound dressings used in hip and knee surgery: Aquacel and Tegaderm versus Cutiplast. Ann R Coll Surg Engl 88:18–22CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Hiranandani Orthopaedic Medical Education (HOME), Dr LH Hiranandani HospitalMumbaiIndia

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