Sequential bilateral total knee arthroplasty under 1 anesthetic in patients ≥75 years old

Adili, Anthony; Bhandari, Mohit; Petruccelli, Danielle; Beer, Justin de

doi:10.1054/arth.2001.21495

Cited by 97 publications

(68 citation statements)

References 19 publications

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“…We found advanced age was an independent risk factor for increased early complications and mortality after TKA surgery, thus confirming the observation of other authors [1,6,44,55,63,70]. Patients between the ages of 65 and 84 years had a fivefold higher chance and those over 85 years a 22-fold higher chance of mortality after TKA than those aged 45 to 64 years.…”

Section: Discussionsupporting

confidence: 91%

“…However, the use of simultaneous BTKA remains the subject of intense debate [55,60,76]. Despite the suggestion by some authors that the rate of medical complications is low [2, 26-29, 35, 36, 51, 52, 59, 64, 65, 67, 72, 74, 78, 79], others [1,4,10,11,42,44,49,53,62,63], including reports based on a recent meta-analysis [60], have questioned its safety.…”

Section: Introductionmentioning

confidence: 99%

“…To overcome the previously mentioned limitations, we used data collected in the National Hospital Discharge Survey to answer the following research questions: (1) What are the patient demographics, comorbidity profiles, hospital characteristics, in-hospital complications, and mortality of patients undergoing BTKA in the United States? (2) How do the previously mentioned variables compare with those of patients undergoing UTKA and RTKA?…”

Section: Introductionmentioning

confidence: 99%

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In-hospital Complications and Mortality of Unilateral, Bilateral, and Revision TKA: Based on an estimate of 4,159,661 Discharges

Memtsoudis

Valle

Besculides

et al. 2008

Clinical Orthopaedics &Amp; Related Research

177

136

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Patients undergoing bilateral total knee arthroplasty (BTKA) may have higher complication rates and mortality than those undergoing a unilateral procedure (UTKA). To evaluate this hypothesis, we analyzed nationally representative data collected for the National Hospital Discharge Survey on discharges after BTKA, UTKA, and revision TKA (RTKA) between 1990 and 2004. The demographics, comorbidities, in-hospital stay, complications, and mortality of each procedure were compared. An estimate of 4,159,661 discharges (153,259 BTKAs; 3,672,247 UTKAs; 334,155 RTKAs) were included. Patients undergoing BTKA were younger (1.5 years) and had a lower prevalence of comorbidities for hypertension (versus UTKA), diabetes, pulmonary disease, and coronary artery disease (versus UTKA and RTKA). The length of hospitalization was 5.8 days for BTKA, 5.3 for UTKA, and 5.4 for RTKA. Despite similar length of hospitalization, the prevalence of procedure-related complications was higher for BTKA (12.2%) compared with UTKA (8.2%) and RTKA (8.7%). In-hospital mortality was highest for patients undergoing BTKA (BTKA, 0.5%; UTKA, 0.3%; RTKA, 0.3%). Patients undergoing BTKA had a 1.6 times higher rate of procedure-related complications and mortality compared with those undergoing UTKA. Outcomes for patients undergoing RTKA for most variables were similar to those for UTKA. BTKA, advanced age, and male gender were independent risk factors for complications and mortality after TKA. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In-hospital Complications and Mortality of Unilateral, Bilateral, and Revision TKA: Based on an estimate of 4,159,661 Discharges

Memtsoudis

Valle

Besculides

et al. 2008

Clinical Orthopaedics &Amp; Related Research

177

136

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“…Although quadriceps strength has been investigated extensively [5-7, 24-28, 41, 42], less investigation has focused on the strength of other lower extremity muscles before and after TKA [1]. In particular, few studies have evaluated hamstrings muscle strength [5,21,39,44], and those that measured hamstrings strength did so months to years after surgery [39,44].…”

Section: Introductionmentioning

confidence: 99%

Quadriceps and Hamstrings Muscle Dysfunction after Total Knee Arthroplasty

Stevens-Lapsley

Balter

Kohrt

et al. 2010

Clinical Orthopaedics &Amp; Related Research

147

131

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Background/rationale Although TKA reliably reduces pain from knee osteoarthritis, full recovery of muscle strength and physical function to normal levels is rare. We presumed that a better understanding of acute changes in hamstrings and quadriceps muscle performance would allow us to enhance early rehabilitation after TKA and improve long-term function. Questions/purposes The purposes of this study were to (1) evaluate postoperative quadriceps and hamstrings muscle strength loss after TKA and subsequent recovery using the nonoperative legs and healthy control legs for comparison, and (2) measure hamstrings coactivation before and after TKA during a maximal isometric quadriceps muscle contraction and compare with nonoperative and healthy control legs. Methods We prospectively followed 30 patients undergoing TKA at 2 weeks preoperatively and 1, 3, and 6 months postoperatively and compared patient outcomes with a cross-sectional cohort of 15 healthy older adults. Bilateral, isometric strength of the quadriceps and hamstrings was assessed along with EMG measures of hamstrings coactivation during a maximal isometric quadriceps contraction. Results There were no differences in strength loss or recovery between the quadriceps and hamstrings muscles of the operative leg throughout the followup, although differences existed when compared with nonoperative and healthy control legs. Hamstrings muscle coactivation in the operative leg during a maximal quadriceps effort was elevated at 1 month (144.5%) compared to the nonoperative leg. Conclusions Although quadriceps dysfunction after TKA typically is recognized and addressed in postoperative therapy protocols, hamstrings dysfunction also is present and should be addressed. Clinical Relevance Quadriceps and hamstrings muscle strengthening should be the focus of future rehabilitation programs to optimize muscle function and long-term outcomes.

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“…However, whether simultaneous BTKA or two-staged unilateral TKA carry higher risks, remains controversial, and a matter of debate. Most previous studies have focused on the outcome of unilateral TKA, and data regarding bilateral TKA are limited (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Staged Bilateral and Simultaneous Bilateral Total Knee Arthroplasty in Deep Vein Thrombosis Occurrence

Sarzaeem¹,

Omrani²,

Abousaidi³

et al. 2017

Trauma Mon

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Background: The present study aimed at determining the incidence of deep venous thrombosis (DVT) in 2 groups of patients who underwent simultaneous bilateral total knee arthroplasty (BTKA) or staged bilateral TKA. Methods: Patients with bilateral knee osteoarthritis, who were candidates for BTKA, were divided into 2 groups of patients undergoing either simultaneous bilateral or staged TKA. Incidence of DVT was measured during a 38-month follow-up period and compared between the 2 groups.

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Sequential bilateral total knee arthroplasty under 1 anesthetic in patients ≥75 years old

Cited by 97 publications

References 19 publications

In-hospital Complications and Mortality of Unilateral, Bilateral, and Revision TKA: Based on an estimate of 4,159,661 Discharges

In-hospital Complications and Mortality of Unilateral, Bilateral, and Revision TKA: Based on an estimate of 4,159,661 Discharges

Quadriceps and Hamstrings Muscle Dysfunction after Total Knee Arthroplasty

Comparison of Staged Bilateral and Simultaneous Bilateral Total Knee Arthroplasty in Deep Vein Thrombosis Occurrence

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