Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients
Abstract Background An increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patie...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-018-0720-6 |
| _version_ | 1798004086224715776 |
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| author | Hirotaka Mutsuzaki Arata Watanabe Tetsuya Komatsuzaki Tomonori Kinugasa Kotaro Ikeda |
| author_facet | Hirotaka Mutsuzaki Arata Watanabe Tetsuya Komatsuzaki Tomonori Kinugasa Kotaro Ikeda |
| author_sort | Hirotaka Mutsuzaki |
| collection | DOAJ |
| description | Abstract Background An increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patients. Methods Sixty-seven patients who received one-stage bilateral TKAs for osteoarthritis who were American Society of Anesthesiology (ASA) class 1 or 2 were included in this study. Perioperative complications, blood loss, transfusion rate, blood laboratory results, and clinical results were evaluated up to 1 year after surgery. Results No major complications (deep infection, pulmonary embolism, cerebrovascular accident, myocardial infarction, death, or removal or revision of the implants) were observed. The average total blood loss was 1139.5 ml. The transfusion rate was 95.5%. Postoperative hemoglobin level and C-reactive protein level gradually improved up to postoperative day 21 (P < 0.01). Bilateral knee extension knee angles and clinical scores improved postoperatively as compared with preoperative values (P < 0.01). Conclusions Although total blood loss and transfusion rate can be high, this preliminary case series suggested that the one-stage bilateral TKA in ASA class 1 or 2 patients can have high perioperative safety levels, and good clinical results can be obtained up to 1 year after surgery. If low-risk patients are selected for bilateral TKA, a one-stage procedure can be beneficial for patients, with a minimal increase in the risk of complications. |
| first_indexed | 2024-04-11T12:17:58Z |
| format | Article |
| id | doaj.art-2bec4bc6c89f47e68406ccb2942f54bf |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T12:17:58Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-2bec4bc6c89f47e68406ccb2942f54bf2022-12-22T04:24:12ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2018-01-011311510.1186/s13018-018-0720-6Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patientsHirotaka Mutsuzaki0Arata Watanabe1Tetsuya Komatsuzaki2Tomonori Kinugasa3Kotaro Ikeda4Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health SciencesDepartment of Orthopaedic Surgery, Ichihara HospitalDepartment of Anesthesiology, Ichihara HospitalDepartment of Orthopaedic Surgery, Ichihara HospitalDepartment of Orthopaedic Surgery, Ichihara HospitalAbstract Background An increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patients. Methods Sixty-seven patients who received one-stage bilateral TKAs for osteoarthritis who were American Society of Anesthesiology (ASA) class 1 or 2 were included in this study. Perioperative complications, blood loss, transfusion rate, blood laboratory results, and clinical results were evaluated up to 1 year after surgery. Results No major complications (deep infection, pulmonary embolism, cerebrovascular accident, myocardial infarction, death, or removal or revision of the implants) were observed. The average total blood loss was 1139.5 ml. The transfusion rate was 95.5%. Postoperative hemoglobin level and C-reactive protein level gradually improved up to postoperative day 21 (P < 0.01). Bilateral knee extension knee angles and clinical scores improved postoperatively as compared with preoperative values (P < 0.01). Conclusions Although total blood loss and transfusion rate can be high, this preliminary case series suggested that the one-stage bilateral TKA in ASA class 1 or 2 patients can have high perioperative safety levels, and good clinical results can be obtained up to 1 year after surgery. If low-risk patients are selected for bilateral TKA, a one-stage procedure can be beneficial for patients, with a minimal increase in the risk of complications.http://link.springer.com/article/10.1186/s13018-018-0720-6One-stage bilateral total knee arthroplastyComplicationsClinical resultsBlood lossSafety |
| spellingShingle | Hirotaka Mutsuzaki Arata Watanabe Tetsuya Komatsuzaki Tomonori Kinugasa Kotaro Ikeda Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients Journal of Orthopaedic Surgery and Research One-stage bilateral total knee arthroplasty Complications Clinical results Blood loss Safety |
| title | Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients |
| title_full | Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients |
| title_fullStr | Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients |
| title_full_unstemmed | Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients |
| title_short | Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients |
| title_sort | investigation of perioperative safety and clinical results of one stage bilateral total knee arthroplasty in selected low risk patients |
| topic | One-stage bilateral total knee arthroplasty Complications Clinical results Blood loss Safety |
| url | http://link.springer.com/article/10.1186/s13018-018-0720-6 |
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