Quality of life after staged bilateral total knee arthroplasty: a minimum five-year follow-up study of seventy-eight patients



Although many studies have been performed to evaluate the quality of life (QOL) and patient satisfaction after total knee arthroplasty (TKA), almost all evaluations were performed in patients after unilateral TKA or in patients after mixed unilateral and bilateral TKA. Accordingly, this study aimed to evaluate QOL after staged bilateral TKA.


A total of 78 patients who underwent staged bilateral TKA for varus knee osteoarthritis were included in this study. All patients had longitudinal follow-up evaluations for at least five years. QOL was assessed by the Japanese Knee Osteoarthritis Measure (JKOM), a disease-specific and patient-derived QOL measure for Japanese patients. Conventional objective outcome scales, including the Knee Society Score and the Timed Up and Go test, were also assessed. In addition, QOL and objective outcomes were compared between the younger (≤ 80 years, average 75.8 years) and older (> 80 years, average 84.7 years) age groups at the final follow-up.


Improvements in both JKOM and objective outcomes reached a plateau one year after staged bilateral TKA. Improvements were prolonged for more than five years. There were no statistically significant differences in JKOM or objective outcomes between the younger and older age groups, despite an 8.9-year difference in the average age.


This was the first longitudinal study to evaluate QOL and objective outcomes after staged bilateral TKA for a period of at least five years. Improvements in QOL and objective outcomes reached a plateau one year after staged bilateral TKA and were prolonged for more than five years. No significant differences were observed in outcome scores between the younger and older age groups.

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We thank Mr. Yasuhiro Kikuchi for his help with data collection.

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Correspondence to Takehiko Sugita.

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The authors declare that they have no conflict of interest.

Ethical approval

The study protocol was approved by the Institutional Review Board of Tohoku Orthopaedic Clinic (approval number 2006-003). Written informed consent for the use of data in the study was obtained from all patients.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Sugita, T., Miyatake, N., Aizawa, T. et al. Quality of life after staged bilateral total knee arthroplasty: a minimum five-year follow-up study of seventy-eight patients. International Orthopaedics (SICOT) 43, 2309–2314 (2019). https://doi.org/10.1007/s00264-018-4196-0

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  • Total knee arthroplasty
  • Osteoarthritis
  • Quality of life
  • Longitudinal evaluation
  • Japanese Knee Osteoarthritis Measure