The interval between staged bilateral total knee arthroplasties does not affect early complications of the second knee or long-term function of the first and second knees

Feng Ji; Zhenguo Zhao; Lei Zhang; Tongkai Liu; Baoqiang Xu; Wei Li; Shuai Yang; Tianrui Wang

doi:10.1186/s12893-024-02442-y

The interval between staged bilateral total knee arthroplasties does not affect early complications of the second knee or long-term function of the first and second knees

BMC Surg. 2024 May 14;24(1):152. doi: 10.1186/s12893-024-02442-y.

Authors

Feng Ji^#¹, Zhenguo Zhao^#¹, Lei Zhang¹, Tongkai Liu¹, Baoqiang Xu¹, Wei Li¹, Shuai Yang², Tianrui Wang³

Affiliations

¹ Department of Orthopedics, The Affiliated Hospital of Jining Medical University, No. 89, Guhuai Road, Jining, 272000, Shandong, China.
² Institute of Orthopedics, Hebei Medical University Third Hospital, No.139 Ziqiang Road, Shijiazhuang, 050000, Hebei, China. qduys123@163.com.
³ Department of Orthopedics, The Affiliated Hospital of Qingdao University, No. 59, Haier Road, Qingdao, 266000, Shandong, China. Tianruiwang2010@163.com.

^# Contributed equally.

Abstract

Background: This study explored the optimal time interval between staged bilateral total knee arthroplasty (BTKA) to minimize early complications of the second TKA and maximise the long-term function of the first and second knees.

Methods: We retrospectively reviewed 266 patients who underwent staged BTKA between 2013 and 2018. Groups 1-4 had time intervals between BTKAs of 1-6, 6-12, 12-18, and 18-24 months, respectively. Demographics, postoperative complications within 90 days of the second TKA, Knee Society Score (KSS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score were compared among the groups.

Results: In total, 54, 96, 75, and 41 patients were assigned to groups 1-4, respectively. Although group 1 had the highest overall complication rate (11.11%), there was no significant difference in the complication rate among the four groups. Also, no significant differences were found among the four groups in functional and patient-reported outcomes, in either the first or second knee at 5 years postoperatively, including KSS-knee, KSS-function, WOMAC-pain, WOMAC-stiffness, and WOMAC-physical function. The interval between BTKA did not influence complications or the function of the second knee. The TKA type (posterior-stabilised vs. medial-pivot) and age did not correlate significantly with any scores.

Conclusions: There was no group difference in early complications of the second TKA, and postoperative function was equivalent between the two knees and did not vary by the interval between surgeries. The results of this study give surgeons and patients more choices. If patients cannot tolerate severe symptoms in the contralateral knee after the first TKA, the second TKA should be performed as early as possible. If knee joint function is not well recovered after the first TKA, and patients are anxious to undergo the second TKA, surgeons can advise patients to postpone the operation based on these results.

Keywords: Bilateral total knee arthroplasty; Complications; Functional outcome; Staged.

MeSH terms

Aged
Arthroplasty, Replacement, Knee* / adverse effects
Arthroplasty, Replacement, Knee* / methods
Female
Humans
Male
Middle Aged
Osteoarthritis, Knee / surgery
Postoperative Complications* / epidemiology
Postoperative Complications* / etiology
Recovery of Function
Retrospective Studies
Time Factors