Simultaneous Bilateral Total Knee Replacement – Current Evidence Based Management Strategy
Vol 3 | Issue 2 | July-Dec 2018 | Page 22-29 | Abhishek Patil, Nandan Rao.
Authors: Abhishek Patil [1], Nandan Rao [2].
[1] Department of Joint Replacement and Orthopaedics, Sahyadri Superspeciality Hospital Hadapsar, Pune, Maharashtra, India
[2] Department of Orthopaedics Reliance Hospital, Navi Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Abhishek Patil, Sahyadri Superspeciality Hospital, Survey number 163, Bhosale nagar, Pune-Solapur road, Hadapsar, Pune. 411028
Email- abhipatortho@gmail.com
Abstract
With an ever-increasing geriatric population and associated knee arthritis; the number of patients requiring total knee arthroplasty continues to rise. In India 94% of patients with Kellegren-Lawrence grade 3 or 4 arthritis have bilateral arthritis. As such bilateral knee arthroplasty offers the convenience of single surgery, concomitant recovery and rehab of both knees and significant cost savings. However traditionally simultaneous bilateral knee replacement has been associated with higher mortality- both in hospital and after discharge extending up to 1 year and higher morbidity due to cardio-pulmonary complications, deep vein thrombosis, pulmonary embolism and higher rates of readmissions. With modern day surgical refinements and improved anesthetic practices; recent studies have reported results and complications at par with unilateral and staged bilateral total knee arthroplasty. However controversies do remain over the applicability of doing simultaneous bilateral knee arthroplasty. Ethical considerations and rarity of complications have made it difficult to conduct adequately powered randomized trials to justify or refute the practice of simultaneous bilateral knee arthroplasty. This review tries to amalgamate the views of recent literature to give the present status and best practices in simultaneous bilateral total knee arthroplasty.
Keywords: Total knee arthroplasty, bilateral total knee arthroplasty, bilateral knee replacement, knee arthritis, knee arthroplasty, knee replacement.
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| How to Cite this article: Patil A, Rao N. Simultaneous Bilateral Total Knee Replacement – Current Evidence Based Management Strategy. Journal of Clinical Orthopaedics July-Dec 2018; 3(2):22-29. |
