Comparison of curative effect of bilateral total knee replacement with different operation plan / 新乡医学院学报

ABSTRACT

Objective To explore curative effect of bilateral total knee replacement (TKA) under different operative strategies of one stage,several stages in a single hospitalization and several hospitalizations.Methods Two hundred and thirty-two patients with bilateral total knee arthroplasty (TKA) were divided into same stage group (98 cases),stage 1 group (85 cases) and stage 2 group (49 cases) according to operative strategies,all the patients were given bilateral TKA.Patients in the same stage group were given bilateral TKA in the same stage,patients in stage 1 group were given one side operation,and the other side were given operation after 7 to 14 days,while the operation time interval were 15 days to one year in stage 2 group.The total operation time,blood transfusion and total hospital stay and postoperative complications were compared among the three groups.The knee joint function after one year of operation was evaluated by the score of the hospital for special surgery (HSS).Results Blood transfusion of stage 1 and 2 group was lower than that of the same stage group significantly (P ＜ 0.01),and total hospital stay was higher than that of the same stage group significantly (P ＜0.01).There was no significant difference in blood transfusion between stage 1 group and stage 2 group(P ＞ 0.05).There was no significant difference in total operation time among the three groups(P ＞ 0.05).There was no significant difference in the incidence of postoperative complications including wound infection,pulmonary embolism,deep venous thrombosis of lower limb and cardiovascular system complications among the three groups(P ＞ 0.05).One year after operation,the HSS scores of the three groups were significantly higher than those before operation (P ＜ 0.05),there was no significant difference in the and HSS score at one year after operation among the three groups (P ＞ 0.05).Conclusion Although the blood transfusion of patients in several stages operation is lower and the hosptital stay is longer than those in the one stage operation,both one stage and several stages operation can achieve better clinical effect in improving the function of knee joint,and the operation safety are consistent.