Skip to main content

Bilateral unicompartmental knee arthroplasty: one stage or two stages?

MUSCULOSKELETAL SURGERY volume 103, pages 231–236 (2019)Cite this article

Abstract

Background

Bilateral unicompartmental knee arthroplasty (UKA) may be performed as one- or two-stage procedure. Previous reports suggest that UKA provides a more rapid functional recovery than total knee arthroplasty. However, little data exist on whether bilateral UKA can be performed without increasing the perioperative risk compared with unilateral cases.

Methods

We retrospectively compared 51 patients treated between January 2014 and March 2017 with single-stage UKA (group A) with 51 patients who underwent unilateral procedure (group B) to evaluate perioperative complications. We noted no statistically significant difference between the two groups in terms of gender, age and body mass index.

Results

Patients who underwent single-stage bilateral UKA had longer operating room time with respect to single procedure (93.2 min vs. 50.7 min). However, the bilateral group had a shorter cumulative operating room time (93.2 min) compared to the unilateral group (101.5 min) with a statistically significant difference (p < 0.05). Average hemoglobin loss at discharge was 3.1 points for group A and 2.4 for group B, with a statistically significant difference (p < 0.05).

Conclusion

Our results demonstrated that bilateral simultaneous UKA does not increase the risk for perioperative complications. Total blood loss at discharge is statistically higher in bilateral UKA rather than unilateral UKA; however, cumulative hemoglobin loss is statistically lower in bilateral group. Patients can benefit from a single hospital admission and anesthetic time, while the shorter total inpatient stay and lower blood loss can reduce hospital costs in cases of bilateral surgery.

Level of evidence IV

Retrospective study.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Meehan JP, Danielsen B, Tancredi DJ, Kim S, Jamali AA, White RH (2011) A population-based comparison of the incidence of adverse outcomes after simultaneous-bilateral and staged-bilateral total knee arthroplasty. J Bone Joint Surg Am 93(23):2203–2213

    Article  Google Scholar 

  2. Sayeed SA, Sayeed YA, Barnes SA, Pagnano MW, Trousdale RT (2011) The risk of subsequent joint arthroplasty after primary unilateral total knee arthroplasty, a 10-year study. J Arthroplast 26(6):842–846

    Article  Google Scholar 

  3. Berend KR, Morris MJ, Skeels MD, Lombardi AD Jr, Adams JB (2010) Perioperative complications of simultaneous versus staged unicompartmental knee arthroplasty. Clin Orthop Relat Res 469:168–173

    Article  Google Scholar 

  4. Chen JY, Lo NN, Jiang L, Chong HC, Tay DK, Chin PL et al (2013) Simultaneous versus staged bilateral unicompartmental knee replacement. Bone Joint J 95(6):788–792

    Article  Google Scholar 

  5. Macario A, Schilling P, Rubio R, Goodman S (2003) Economics of one-stage versus two-stage bilateral total knee arthroplasties. Clin Orthop Relat Res 414:149–156

    Article  Google Scholar 

  6. 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 Arthroplast 13(2):172–179

    CAS  Article  Google Scholar 

  7. Levy YD, Hardwick ME, Copp SN, Rosen AS, Colwell CW Jr. (2012) Thrombosis incidence in unilateral vs. simultaneous bilateral total knee arthroplasty with compression device prophylaxis. J Arthroplast 28(3):474–478

    Article  Google Scholar 

  8. March LM, Cross M, Tribe KL, Lapsley HM, Courtenay BG, Cross MJ et al (2004) Patient costs and outcomes following bilateral and unilateral total knee joint replacement surgery for OA. Osteoarthr Cartil 12(5):400–408

    CAS  Article  Google Scholar 

  9. Memtsoudis SG, Ma Y, González Della Valle A, Mazumdar M, Gaber-Baylis LK, MacKenzie CR et al (2009) Perioperative out- comes after unilateral and bilateral total knee arthroplasty. Anesthesiology 111(6):1206–1216

    Article  Google Scholar 

  10. 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(8):1532–1537

    Article  Google Scholar 

  11. Lombardi AV Jr, Berend KR, Walter CA, Aziz-Jacobo J, Cheney NA (2009) Is recovery faster for mobile-bearing unicompartmental than total knee arthroplasty? Clin Orthop Relat Res 467:1450–1457

    Article  Google Scholar 

  12. Newman J, Pydisetty RV, Ackroyd C (2009) Unicompartmental or total knee replacement: the 15-year results of a prospective randomized controlled trial. J Bone Joint Surg Br 91:52–57

    CAS  Article  Google Scholar 

  13. Price AJ, Waite JC, Svard UC (2005) Long-term clinical results of the Oxford medial unicompartmental knee arthroplasty. Clin Orthop Relat Res 435:171–180

    Article  Google Scholar 

  14. Memtsoudis SG, Besculides MC, Reid S, Gaber-Baylis LK, Gonzalez Della Valle A (2009) Trends in bilateral total knee arthroplasties: 153,259 discharges between 1990 and 2004. Clin Orthop Relat Res 467(6):1568–1576

    Article  Google Scholar 

  15. Severson EP, Mariani EM, Bourne MH (2009) Bilateral total knee arthroplasty in patients 70 years and older. Orthopedics 32(5):316

    Article  Google Scholar 

  16. Forster MC, Bauze AJ, Bailie AG, Falworth MS, Oakeshott RD (2006) A retrospective comparative study of bilateral total knee replacement staged at a one-week interval. J Bone Joint Surg Br 88(8):1006–1010

    CAS  Article  Google Scholar 

  17. Kim YH, Choi YW, Kim JS (2009) Simultaneous bilateral sequential total knee replacement is as safe as unilateral total knee replacement. J Bone Joint Surg Br 91(1):64–68

    Article  Google Scholar 

  18. Stanley D, Stockley I, Getty CJ (1990) Simultaneous or staged bilateral total knee replacements in rheumatoid arthritis. A prospective study. J Bone Joint Surg Br 72(5):772–774

    CAS  Article  Google Scholar 

  19. Hooper GJ, Hooper NM, Rothwell AG, Hobbs T (2009) Bilateral total joint arthroplasty: the early results from the New Zealand National Joint Registry. J Arthroplasty 24(8):1174–1177

    Article  Google Scholar 

  20. Chan WC, Musonda P, Cooper AS, Glasgow MM, Donell ST, Walton NP (2009) One-stage versus two-stage bilateral unicompartmental knee replacement: a comparison of immediate post-operative complications. J Bone Joint Surg Br 91(10):1305–1309

    CAS  Article  Google Scholar 

  21. Akhtar KS, Somashekar N, Willis-Owen CA, Houlihan-Burne DG (2014) Clinical outcomes of bilateral single-stage unicompartmental knee arthroplasty. Knee 21(1):310–314

    CAS  Article  Google Scholar 

  22. Ma T, Tu YH, Xue HM, Wen T, Cai MW (2015) Clinical outcomes and risks of single-stage bilateral unicompartmental knee arthroplasty viaOxford Phase III. Chin Med J (Engl) 5;128(21):2861–2865

    Article  Google Scholar 

  23. Romagnoli S, Zacchetti S, Perazzo P, Verde F, Banfi G, Viganò M (2015) Onsets of complications and revisions are not increased after simultaneous bilateral unicompartmental knee arthroplasty in comparison with unilateral procedures. Int Orthop 39(5):871–877

    Article  Google Scholar 

Download references

Author information

Affiliations

  1. Orthopaedic Department, Humanitas Gavazzeni, Via M. Gavazzeni 21, Bergamo, Italy

    A. Biazzo, F. Masia & F. Verde

Authors
  1. A. Biazzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. F. Masia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Verde
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Biazzo.

Ethics declarations

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

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

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Biazzo, A., Masia, F. & Verde, F. Bilateral unicompartmental knee arthroplasty: one stage or two stages?. Musculoskelet Surg 103, 231–236 (2019). https://doi.org/10.1007/s12306-018-0579-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-018-0579-z

Keywords

  • Unicompartmental knee arthroplasty
  • Bilateral
  • Soft-tissue sparing surgery
  • Two-stage UKA