Reduction Osteotomy versus Extensive Release on Clinical Outcome Measures in Simultaneous Bilateral Total Knee Arthroplasty

Abstract

BackgroundDuring total knee arthroplasty (TKA) in varus knee deformities, reduction osteotomy (RO) and medial soft tissue release are alternative techniques to aid in achieving deformity correction. In this study, we investigated the effect of RO compared to extensive medial soft tissue release (ER) on clinical outcome measures in simultaneous bilateral TKA.Material/MethodsWe prospectively enrolled 24 patients (48 knees) with bilateral varus knee deformity from July 2014 to December 20l5. For each patient, one knee was assigned to the RO group and the contralateral knee was assigned to ER group. One year postoperative, follow-up outcomes were collected and analyzed.ResultsTime to 90° flexion of the knee was significantly different in the RO group (1.6±0.3 days) compared to the ER group (2.0±0.4 days) (p<0.001). Using a 10-item patient reported outcome questionnaire, total scores were significantly different between the RO group (86.3±3.2) and the ER group (82.4±2.7) (p<0.001). Analysis of variance showed a significant difference on the visual analogue scale (VAS) score (p<0.001) but no significant difference in the range of motion (ROM) of the knee (p>0.05) during the follow-up year.ConclusionsKnees treated with RO were associated with greater improvements in pain and function than knees treated with conventional ER technique. Additionally, RO technique did not confer an increased risk for adverse clinical outcomes. RO may therefore by a safe method to decrease postoperative pain, achieve earlier functional recovery, and increase patients’ subjective satisfaction after TKA.

Changes in perioperative hemoglobin and hematocrit in patients undergoing total knee arthroplasty: a prospective observational study of optimal timing of measurement

“…Total knee arthroplasty (TKA) is a successful, safe, and cost-effective surgical procedure to relieve pain, correct deformity, and restore function in patients with end-stage knee arthritis. 1 , 2 However, TKA has long been associated with significant decreases in the hemoglobin (Hb) concentration and hematocrit (Hct) because of perioperative visible and hidden blood loss. In such cases, blood transfusion is not uncommon in the early postoperative period, placing patients at risk of transfusion reactions.…”

Changes of perioperative hemoglobin and hematocrit levels in patients receiving total knee arthroplasty, a prospective observational study for an optimal timing of determination

“…Total knee arthroplasty (TKA) is a successful, safe and cost-effective surgical procedure for endstaged knee arthritis to relieve pain, correct deformity and restore function [1,2]. However, TKA has long been associated with significant drop on thehemoglobin (Hb) and Hematocrit (Hct) levels because of perioperative visible and hidden blood loss, under which a blood transfusion is not uncommon in the early postoperative period thus rendering the patients at risks of transfusion reactions [3].…”