scholarly journals Comparison of functional outcome of simultaneous and staged bilateral total knee arthroplasty : systematic review of literature

2021 ◽  
Vol 87 (3) ◽  
pp. 487-493
Author(s):  
Irfan Qadir ◽  
Latif Khan ◽  
Jahanzeb Mazari ◽  
Umair Ahmed ◽  
Atiq uz Zaman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Functional Outcome ◽  
Contemporary Literature ◽  
Oxford Knee Score ◽  
Bilateral Total Knee Arthroplasty ◽  
Significant Difference ◽  
Functional Scores ◽  
Total Knee ◽  
Central Database ◽  
Simultaneous Bilateral Tka

Safety of simultaneous bilateral TKA (simBTKA) and staged BTKA (staBTKA) have been compared in previous systematic reviews but functional outcome remains neglected aspect of the debate. We performed a systematic review of contemporary literature to compare the functional outcome of simBTKA and staBTKA. We searched PubMed/MEDLINE, EMBASE and Cochrane Central Database to identify all articles published between 2000 and July 2020 that evaluated the outcome of patients undergoing BTKA either in simultaneous or staged manner. Ten articles were identified which met the inclusion criteria. Functional outcome was reported in terms of Knee Society score (KSS), range of motion (ROM), Oxford Knee Score (OKS) and Western Ontario and McMaster University score (WOMAC) in seven, five, four and two studies respectively. KSS gained on average 66.6 points (47.5-95.3) for simBTKA and 65.1 points (44.4-97.2) for staBTKA without significant difference between two groups. There was no difference in post-operative ROM (maximum post-operative flexion being 124.4 and 125.1 for simBTKA and staBTKA groups respectively). Mean improvement in OKS ranged from 20 to 32.6 for simBTKA and 21.6 to 33.1 for staBTKA. There was moderate evidence to suggest that both simultaneous BTKA and staged BTKA produce equivalent improvement in functional scores.

scholarly journals Comparative study on functional outcome, complication and readmission rate in bilateral simultaneous versus staggered versus staged total knee replacement: a retrospective study

2020 ◽  
Vol 6 (4) ◽  
pp. 783
Author(s):  
Vishal Ashokraj Pushkarna ◽  
A. V. Gurava Reddy
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Complication Rate ◽  
Readmission Rate ◽  
Oxford Knee Score ◽  
Readmission Rates ◽  
Bilateral Total Knee Arthroplasty ◽  
Kujala Score ◽  
Simultaneous Group ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> An important source of debate in orthopaedic practices is the choice of performing simultaneously, staggered or staged bilateral total knee arthroplasty (BTKA). Many studies are available which compare bilateral simultaneous vs staged TKA in terms of functional outcome. But still there are no studies which include staggered BTKA (done in a single hospital stay) and compared their functional outcome, associated complication with a 90 days readmission rate.</p><p class="abstract"><strong>Methods:</strong> A retrospective review of 300 TKAs patients who underwent bilateral TKA. Patients were divided into three groups with 100 patients each in simultaneous, staggered, staged group. We use hospital electronic health records database to compare the complication and readmission rates in all three groups. Functional outcome was evaluated pre-operatively using knee society score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Oxford knee score, Kujala score and range of motion.<strong></strong></p><p class="abstract"><strong>Results:</strong> The study consists of 234 females and 66 males, among which maximum females were in a simultaneous group while male where more in staggered group. Mean age group in our study was 62.25%. ASA score of 3 was significantly more in staged group. Patient in the staggered group had a better KSS and Kujala score with better range of motion and less readmission and complication rate. Simultaneous BTKA had slightly higher complication rate.</p><p class="abstract"><strong>Conclusions:</strong> This study demonstrates that there is not big significant in functional outcome when comparing simultaneous, staged and staggered bilateral TKA, but still staggered group shows better postoperative functional outcome.</p>

scholarly journals Should a Patients BMI Status be Used to Restrict Access to Total Hip and Knee Arthroplasty? Functional Outcomes of Arthroplasty Relative to BMI - Single Centre Retrospective Review

2013 ◽  
Vol 7 (1) ◽  
pp. 594-599 ◽  
Author(s):  
H. Lash ◽  
G. Hooper ◽  
N. Hooper ◽  
C. Frampton
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Preoperative Assessment ◽  
Total Hip ◽  
Significant Difference ◽  
Functional Scores ◽  
Hip And Knee Arthroplasty ◽  
Total Knee

We reviewed the experience of a dedicated orthopaedic elective service to determine whether we could establish a BMI group where arthroplasty was no longer effective as assessed by the patient’s functional outcome. This was a prospective observational study with retrospective analysis of data collected on 1439 total hip arthroplasty, 934 total knee arthroplasty and 326 unicompartment knee arthroplasty patients. Functional scores (WOMAC, Oxford hip and knee scores and HAAS) were obtained preoperatively and at 12 months post op. Patients had their BMI recorded at the preoperative assessment and were divided into BMI groups (BMI<25, BMI 25-30, BMI 30-35 and BMI > 35). Patients with a BMI of ≤ 30 had significantly better functional scores at 12 months post op compared to those with a BMI of > 35. The absolute gain in functional scores from pre op to 12 months post op did not differ significantly between BMI groups, the only significant difference we found for absolute gain showed patients with a BMI of > 35 have a greater increase in HAAS scores following total hip arthroplasty compared to patients with a BMI of 30 or less (p = 0.0435). Our patients with higher BMI’s had worse preoperative and post operative functional scores but their benefit from surgery measured by the change in functional scores showed no difference compared to patients with lower BMI. We could find no reason on the basis of the 12-month results to limit surgery to obese patients because of an expected poorer functional outcome.

Identifying an Ideal Time Frame for Staged Bilateral Total Knee Arthroplasty to Maximize Functional Outcome

2016 ◽  
Vol 30 (07) ◽  
pp. 682-686 ◽  
Author(s):  
Jerry Chen ◽  
Wu Lee ◽  
Hwei Chong ◽  
Hee Pang ◽  
Darren Tay ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Time Frame ◽  
Complication Rates ◽  
Readmission Rates ◽  
Bilateral Total Knee Arthroplasty ◽  
Sf 36 ◽  
Significant Difference ◽  
Total Knee

Compared with staged bilateral total knee arthroplasty (TKA), simultaneous bilateral TKA carries a higher risk of cardiac complications, pulmonary complications, and mortality, especially in patients with preexisting cardiopulmonary disease or advanced age. However, the period of time between staged TKAs that would eliminate these increased risks has yet to be determined. The purpose of this study is to evaluate complication rates and functional outcome in patients who underwent staged bilateral TKA and to determine an optimal time frame for the second knee. The authors retrospectively reviewed 306 patients who underwent staged bilateral TKA between 2002 and 2013. Patients were grouped into 31 to 90, 91 to 180, 181 to 270, and 271 to 365 days interval, where complication and 90-day readmission rates for the second TKA were identified. Patients were also assessed preoperatively and 2 years postoperatively using the Oxford knee score (OKS) and Short-Form (SF)-36. There was no significant difference in complication and 90-day readmission rates between the various groups. The functional outcome of the knees scored 2 years postoperatively using OKS and SF-36 showed comparable results across all four groups. Thus, the authors could not identify an ideal time frame for performing the second TKA with the objective of maximizing functional outcome.

Sensorimotor training prior total knee arthroplasty and effects on functional outcome: A systematic review and meta-analysis

2021 ◽  
Vol 86 ◽  
pp. 83-93
Author(s):  
José-María Blasco ◽  
David Hernández-Guillen ◽  
Fernando Domínguez-Navarro ◽  
Yolanda Acosta-Ballester ◽  
Yasser Alakhdar-Mohmara ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Sensorimotor Training ◽  
Total Knee

Venous thromboembolism after total knee arthroplasty is associated with a worse functional outcome at one year

2021 ◽  
Vol 103-B (7) ◽  
pp. 1254-1260
Author(s):  
Lorenzo Calabro ◽  
Nick D. Clement ◽  
Deborah MacDonald ◽  
James T. Patton ◽  
Colin R. Howie ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Venous Thromboembolism ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Significant Independent Predictor ◽  
Total Knee ◽  
Five Dimension ◽  
One Year

Aims The primary aim of this study was to assess whether non-fatal postoperative venous thromboembolism (VTE) within six months of surgery influences the knee-specific functional outcome (Oxford Knee Score (OKS)) one year after total knee arthroplasty (TKA). Secondary aims were to assess whether non-fatal postoperative VTE influences generic health and patient satisfaction at this time. Methods A study of 2,393 TKAs was performed in 2,393 patients. Patient demographics, comorbidities, OKS, EuroQol five-dimension score (EQ-5D), and Forgotten Joint Score (FJS) were collected preoperatively and one year postoperatively. Overall patient satisfaction with their TKA was assessed at one year. Patients with VTE within six months of surgery were identified retrospectively and compared with those without. Results A total of 37 patients (1.5%) suffered a VTE and were significantly more likely to have associated comorbidities of stroke (p = 0.026), vascular disease (p = 0.026), and kidney disease (p = 0.026), but less likely to have diabetes (p = 0.046). In an unadjusted analysis, patients suffering a VTE had a significantly worse postoperative OKS (difference in mean (DIM) 4.8 (95% confidence interval (CI) 1.6 to 8.0); p = 0.004) and EQ-5D (DIM 0.146 (95% CI 0.059 to 0.233); p = 0.001) compared with patients without a VTE. After adjusting for confounding variables VTE remained a significant independent predictor associated with a worse postoperative OKS (DIM -5.4 (95% CI -8.4 to -2.4); p < 0.001), and EQ-5D score (DIM-0.169 (95% CI -0.251 to -0.087); p < 0.001). VTE was not independently associated with overall satisfaction after TKA (odds ratio 0.89 (95% CI 0.35 to 2.07); p = 0.717). Conclusion Patients who had a VTE within six months of their TKA had clinically significantly worse knee-specific outcome (OKS) and general health (EQ-5D) scores one year postoperatively, but the overall satisfaction with their TKA was similar to those patients who did not have a VTE. Cite this article: Bone Joint J 2021;103-B(7):1254–1260.

Bipolar Sealers Do not Improve Blood Loss or Functional Outcomes of Primary Total Knee Arthroplasty

2018 ◽  
Vol 33 (01) ◽  
pp. 062-066
Author(s):  
Stefano Pasqualotto ◽  
Guillaume Demey ◽  
Aude Michelet ◽  
Luca Nover ◽  
Mo Saffarini ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Control Group ◽  
Transfusion Rate ◽  
Significant Difference ◽  
Functional Scores ◽  
Bipolar Sealer ◽  
Total Knee ◽  
Without Tourniquet

AbstractSeveral methods were introduced to limit perioperative blood loss in total knee arthroplasty (TKA). By transcollation of soft tissues below 100°C, bipolar sealers intend to reduce bleeding and tissue damage, compared with conventional electrocautery. Existing studies report contradictory findings about the performance of bipolar sealers. The purpose of this study was to evaluate the effect of a bipolar sealer on blood loss, transfusions, hospital length of stay (LOS), and functional scores in primary TKA. In this single-center prospective study, 101 patients, undergoing primary TKA in a fast-track setting without tourniquet use, were randomly assigned to either (1) the study group which was operated with a bipolar sealer or (2) the control group operated with conventional electrocautery. The study cohort comprised 49 men and 52 women, aged 71.1 ± 8.8 years. There was no significant difference between the bipolar sealer group and the control group in terms of blood loss at day 3 (1,240 ± 547.4 vs. 1,376 ± 584.4 mL; p = ns [not significant]), transfusion rate (10 vs. 4%; p = ns), surgery time (48.2 ± 10.8 vs. 46.6 ± 9.1 minute; p = ns) or LOS (4.1 ± 2.7 vs 4.3 ± 2.0 days; p = ns). At a mean follow-up of 63.3 ± 4.9 days, there was no significant difference between the bipolar sealer group and the control group in terms of net improvement of Knee Society Score (KSS) knee (26.0 ± 16.7 vs. 23.7 ± 12.3; p = ns) and KSS function (20.4 ± 19.3 vs. 20.8 ± 19.9; p = ns). Compared with the use of conventional electrocautery in primary TKA without tourniquet, we found no effect of bipolar sealer use on blood loss, transfusion rates, LOS, or functional recovery. This is a Level II, prospective cohort study.

scholarly journals Functional outcome of total knee replacement for inflammatory arthritis of knee

2020 ◽  
pp. 221049172097184
Author(s):  
Madhan Jeyaraman ◽  
Dushyant Chaudhary
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Replacement ◽  
Functional Outcome ◽  
Knee Replacement ◽  
Inflammatory Arthritis ◽  
Bivariate Analysis ◽  
Inflammatory Disorder ◽  
Joint Movement ◽  
Functional Scores ◽  
Total Knee

Introduction: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disorder that involves symmetrical small and large joints. Despite DMARDs, biological agents and anti-inflammatory agents, severe damage to the joint cartilage occurs, mainly due to the growing synovium. Total knee replacement in RA has been an enormous boon to those who are suffering from pain and deformity because of severe restriction of knee joint movement. Objectives: To evaluate the clinical, functional and radiological outcomes after TKR for inflammatory arthropathy and to identify potential factors that affect the functional outcome after TKR for Rheumatoid Arthritis. Materials and Methods: Patients who underwent total knee arthroplasty for rheumatoid arthritis during the period 2011–2018 were recruited for the study after informed consent. The American Knee Society scores and functional scores were used for the functional outcome and assessment. Preoperative scores were obtained from previous medical records. Paired t test was done to determine the significance in changes between the preoperative and postoperative scores. Bivariate analysis using Spearman correlation and logistic regression analysis was performed to assess the influence of various factors on the postoperative knee scores. Results: The average age of patients at the time of TKR was 54 years, all were in stage IV disease, and the majority were women (n = 20). The significant improvement (p = 0.000) was observed between the preoperative (57.3) and postoperative (97.4) Knee Society scores, as well as improvement in functional scores from 36.3 preoperative to 85.2 points postoperatively after TKR. Steroid usage had a significant positive correlation. The duration of disease and involvement of the other joint had a significant negative correlation to postoperative functional scores. Conclusion: Total Knee Replacement has been proved as one of the most successful surgical interventions for reducing pain and enhancing physical function in inflammatory arthritis patients.

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