Cost, safety, and rehabilitation of same-stage, bilateral total knee replacements compared to two-stage total knee replacements

Autor: Kwong-Yin Chung, Ka-Bon Kwok, Jason Chi Ho Fan, Raymond C. W. Wan, Yuk-Wah Hung, Carmen K. M. Lo
Rok vydání: 2021
Předmět:
Zdroj: Knee Surgery & Related Research
Knee Surgery & Related Research, Vol 33, Iss 1, Pp 1-13 (2021)
ISSN: 2234-2451
Popis: BackgroundMany patients experience bilateral knee osteoarthritis and require bilateral total knee replacement (TKR). Same-stage, bilateral TKR is proposed to be a cost-effective and safe solution compared to two-stage, but conflicting results in the literature are reported. We aim to compare the costs, safety, and rehabilitation performance of patients in same-stage versus two-stage, bilateral TKR with our centre’s perioperative protocol.Materials and methodsWe retrospectively reviewed 175 patients (95 same-stage, 80 two-stage) who had undergone bilateral TKR in our centre. Patient selection for same-stage, bilateral TKR was strictly protocol-driven and required fulfilment of all criteria, including age ResultsThe same-stage, bilateral TKR reduced the length of hospital stays by 5.71 days per patient, decreased the operation time by 27.4 min, saved 3.34 (18.6%) physiotherapy sessions, and 3.78 (51.5%) occupational therapy sessions. The same-stage group experienced a higher haemoglobin drop but no significant difference in transfusion percentage, transfusion volume, complication rate, and readmission rate. The two-stage subgroup with anaesthetic risk, age, and BMI similar to the same-stage group showed the same results. Same-stage, bilateral TKR patients experienced no significant difference in final post-operative pain levels and rehabilitation outcomes as two-stage TKR patients.ConclusionThis study showed that same-stage, bilateral TKR can reduce costs, with similar safety profiles and rehabilitation outcomes compared to the two-stage, bilateral TKR.
Databáze: OpenAIRE
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