Bilateral versus unilateral total knee replacement with 35-day morbidity and mortality: A Bi-Centre prospective cohort study

Abstract

Background: Total Knee Replacement (TKR) has been the most successful intervention that reduces knee pain and improves physical function of rheumatoid arthritis patients. This study aims to compare the complications and recovery for bilateral versus unilateral TKR within 35 days of post-surgery. Method: This is a prospective observational study that was done in two medical centres in Saudi Arabia. All patients who underwent primary TKR surgery in the included medical centres between the period of October 2018 till July 2019 were eligible for this study. A prospective data collection sheet was used to follow up for each patient for 35 days of post-surgery. Results: 242 patients were involved in this study. The mean age for unilateral TKR patients was 66.95 ± 8.91 years, whereas 64.53 ± 8.88 years for bilateral TKR patients. Days required to start walking post-operation of unilateral TKR were significantly higher than that of bilateral TKR (2.66 ± 1.13 days versus 2.30 ± 0.98 days). Deep vein thrombosis (DVT) was found in bilateral TKR 11 (4.5%) more than 4 (1.7%) unilateral TKR. Confirmed diagnosis (pulmonary embolism (PE) or DVT) was observed in 10 (4.2%) bilateral TKR more than unilateral TKR 2 (0.8%). Conclusion: There are significant differences between bilateral and unilateral TKR in terms of recovery and DVT complications. Highlights: