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Comparative Study
. 2009 Feb;33(1):101-4.
doi: 10.1007/s00264-007-0447-1. Epub 2007 Sep 14.

The relative safety of one-stage bilateral total knee arthroplasty

J C Luscombe  1 , K Theivendran, A Abudu, S R Carter
Affiliations
Comparative Study

The relative safety of one-stage bilateral total knee arthroplasty

J C Luscombe et al. Int Orthop. 2009 Feb.

Abstract
in English, French

Patients with osteoarthritis of the knee often require bilateral knee replacement before fulfilling their full ambulatory potential. Despite extensive research there is considerable debate about the risks of performing simultaneous bilateral knee replacements under the same anaesthetic. Our aim was to compare the relative short-term morbidity of one-stage bilateral with unilateral total knee arthroplasty in a retrospective, consecutive cohort of patients. Seventy-two bilateral knee replacements were case-matched for age and gender with 144 unilateral knees. One-stage bilateral arthroplasty was associated with increased morbidity with respect to wound (6.0 vs 0.7%; p = 0.003) and deep prosthetic (3.5% vs 0.7 %; p = 0.02) infections, cardiac complications (3.5% vs 0.7%; p = 0.04) and chest infections (7.0% vs 1.4%; p = 0.04). No differences were observed in the mortality rates (p = 0.30) and risk of thrombo-embolism (p = 0.70). We conclude that one-stage bilateral total knee arthroplasty is associated with increased morbidity compared with unilateral knee replacement.

Les patients ayant présenté une ostéoarthrite du genou nécessitent parfois une prothèse du genou bilatérale. Des travaux font état des risques survenant lors de la réalisation d’une prothèse totale unilatérale du genou, risques anesthésiques notamment. Le but de notre étude est de comparer la morbidité à cours terme du remplacement du genou par prothèse unilatérale en un temps d’un côté ou des deux côtés, ceci à propos de l’étude rétrospective d’une cohorte de patients. 72 prothèses totales du genou bilatérales en un temps ont été analysées en terme d’âge, de sexe en comparaison avec 144 prothèses du genou unilatérales. La prothèse totale du genou bilatérale en un temps est associée une augmentation de la morbidité (6.0 vs 0.7% ; p = 0.003) et à un taux d’infection profonde important (3.5% vs 0.7% ; p = 0.02), de même, en ce qui concerne les complications cardiaques (3.5% vs 0.7% ; p = 0.04), les complications pulmonaires (7.0% vs 1.4% ; p = 0.04). Nous n’avons pas observé de différence sur le plan de la mortalité (p = 0.30) de même en ce qui concerne les risques thromboemboliques (p = 0.70). Nous pouvons donc conclure que la prothèse totale du genou bilatérale en un seul temps entraîne une augmentation importante de la morbidité si on l’a compare à la prothèse totale du genou, unilatérale.

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References

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