No difference in the functional improvements between unilateral and bilateral total knee replacements

Yu-Hao Huang,Hung Chang,Chih-Chien Wang,Kwo-Tsao Chiang,Sui-Lung Su,Chin Lin,Leou-Chyr Lin,Jia-Hwa Yang,Man-Gang Lee,Shih-Jen Yeh,Hsueh-Lu Chang,Wen Su,Hsien-Feng Chang,Chih-Yuan Mou

doi:10.1186/s12891-018-2006-x

Abstract

BackgroundDifferences between staged bilateral total knee replacement (TKR) and simultaneous bilateral TKR have been investigated, but few studies have investigated differences in the functional improvements resulting from these methods. Therefore, this study investigates the different functional improvements between staged bilateral total knee TKR and simultaneous bilateral TKR.MethodsAmong 144 potential bilateral TKR patients who were included in this study, 93 (64.6%) patients selected unilateral TKR and 51 (35.4%) selected bilateral TKR. Functional improvements were assessed using the Western Ontario and McMaster University osteoarthritis index (WOMAC) and the Medical Outcomes Trust Short Form-36 (SF-36), and patients were interviewed pre-operatively and after 6 months. A generalized equation was used to test for differences in functional improvements.ResultsAfter TKR, pain, stiffness, function and total WOMAC scores were significantly reduced in both groups, with mean changes from − 26.6 to − 41.4 and from − 27.5 to − 42.2.The mean health change of SF-36 scores, physical component and mental component scores changed to 45.2 ± 18.2, 74.0 ± 15.4 and 77.0 ± 9.6, respectively, in Group 1 and 47.1 ± 17.1, 74.0 ± 15.2 and 75.5 ± 12.1, respectively, in Group 2.Unilateral and simultaneous bilateral TKR produce similar functional improvements, although current work status may be a novel impact factor.ConclusionNo differences in functional improvements were identified between patients who selected unilateral versus bilateral TKR, indicating no recommendation for one procedure over the other.

Highlights

Differences between staged bilateral total knee replacement (TKR) and simultaneous bilateral TKR have been investigated, but few studies have investigated differences in the functional improvements resulting from these methods
An Australian study compared the functional improvements between simultaneous bilateral and unilateral TKR [14], and this study reported that bilateral replacement patients reported better physical function and general health
After TKR, pain, stiffness, function and total Western Ontario and McMaster University osteoarthritis index (WOMAC) scores were significantly reduced in both groups, with mean changes from − 26.6 to − 41.4 and from − 27.5 to − 42.2, respectively

Summary

Introduction

Differences between staged bilateral total knee replacement (TKR) and simultaneous bilateral TKR have been investigated, but few studies have investigated differences in the functional improvements resulting from these methods. This study investigates the different functional improvements between staged bilateral total knee TKR and simultaneous bilateral TKR. Total knee replacement (TKR) is mainly offered to patients with end-stage osteoarthritis (OA) and has become more prevalent in recent years [1]. TKR is an effective intervention that improves quality of life, reduces pain and increases functional capability [2]. Previous studies have investigated differences in responses to staged bilateral and simultaneous bilateral TKR in terms of short-term discomfort [6], morbidity and mortality [7,8,9,10] and cost-effectiveness [11].

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Results

Discussion

Conclusion