Staged vs simultaneous bilateral unicompartmental knee arthroplasty for clinical outcomes

Abstract

Background: Bilateral unicompartmental knee arthroplasty (UKA) can be divided into one or two stages clinically. Compared with staged bilateral UKA, whether simultaneous bilateral UKA has better clinical efficacy remains to be verified. Methods: PubMed, EBSCO, and Web of Science were searched by us for meta-analysis. Studies were considered eligible for inclusion if they included simultaneous and staged UKA. We excluded studies unrelated to the research question, studies in non-selected languages, and studies where the full-text was not available. The data were extracted by two independent investigators, and disagreements were resolved through discussions with a third party. If important data or information about the content of the paper were not available, authors were contacted. Publication bias in studies has been assessed. Meta-analysis was done using Review Manager 5.3. Results: The systematic review and meta-analysis identified 3370 trials, of which 8 studies (963 patients) compared simultaneous with staged bilateral UKA. The meta-analysis showed that the clinical outcomes of simultaneous bilateral UKA goes down in operating time (weighted mean difference [WMD] = −19.34, 95% confidence interval [CI] −22.44 to −16.25, P < .00001), postoperative hemoglobin (Std. mean difference [SMD] = −0.46, 95% CI −0.71 to −0.20, P = .0004), length of stay (LOS) (WMD = −4.73, 95% CI −6.39 to −3.06, P < .00001), hospital cost (SMD = −5.42, 95% CI −6.54 to −4.30, P < .00001). There were no significant difference in blood transfusion, venous thrombosis, infection, cardiac complications, pulmonary complications, Oxford Knee Score (OKS) between simultaneous and staged bilateral UKA. Conclusion: Simultaneous bilateral UKA can effectively reduce the operating time, LOS, and hospital cost without increasing postoperative complications compared to stage bilateral UKA. Registration number: CRD42020160056 ( www.crd.york.ac.uk/prospero/ ).

Prótesis unicompartimental de rodilla

“…Al igual que en otros estudios, creemos que con una adecuada selección de los pacientes no aumenta el riesgo de complicaciones ni se retrasa la rehabilitación en los pacientes operados en un tiempo. 26 Los que se operaron secuencial lo hicieron así porque la segunda rodilla operada presentó síntomas como para requerir la intervención con posterioridad.…”

Advantages of Simultaneous Cementless Bilateral Unicondylar Knee Arthroplasty Compared to Staged Surgery

“…Many studies have found no difference in postoperative functional outcomes between patients with simultaneous and staged UKA. 3 4) In their meta-analysis, Chen et al 18) found no significant difference in postoperative OKS between the simultaneous and staged groups. The median change in VAS scores at the end of the first year in the present study was 6 in the simultaneous group and 5 in the staged group.…”

“… 15 16) A couple of previous studies have compared staged and simultaneous bilateral UKA, but these studies have mainly focused on cemented implants. 17 18) …”

Clinical Outcomes and Complications of Simultaneous or Sequential Bilateral Total Ankle Arthroplasty

“…There is moderate evidence to suggest equivalent improvement in functional outcomes 27 . Similarly, in a systematic review of 8 studies, simultaneous bilateral UKA was shown to effectively reduce the operative time, length of stay, and hospital cost without increasing postoperative complications compared with staged bilateral UKA 28 . Given the different risk-benefit profiles of the 2 procedures, these potential complications must be interpreted for each patient individually.…”