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Surgeons should prefer choosing simultaneous TKA in patients
with OA in both knees as patient satisfaction levels were significantly better
with the second knee in the early stage after simultaneous bilateral TKA.
Elderly population across the world tends to suffer from
osteoarthritis of the knees which could seriously affect their health and
quality of life. Total knee arthroplasty (TKA) is a surgical procedure used to
reduce pain and improve quality of life and function in patients when the
disease progresses and becomes severe. Simultaneous bilateral TKA is an
effective and safe approach for selected patients. The possibility of having
different satisfaction levels between the first and second knee in the early
stage after Shuai Huang et al.
assessed simultaneous bilateral TKA.
A total of 46 patients were retrospectively assessed in the
Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen
University, China between March 2013 and March 2015. Typically, the surgeon
executed first-side TKA (right knee), followed by TKA on the left knee.
Tranexamic acid (TXA) (10 mg/kg) was administered intravenously, and the
tourniquet was released after wound closure. The objective parameters
comprising drainage volume and swelling evaluated by the circumference of the
10 cm above the patella; preoperative KSS (Knee Society Score), ROM (Risk of
Mortality), and pain visual analog scale (VAS) and the preoperative and
postoperative (1st, 3rd, and 7th days)
subjective parameters comprising pain, patient satisfaction and VAS of the
first and second surgeries for each knee were investigated.
On comparison of simultaneous bilateral TKA, the first-side
TKA (right knee) showed lower mean drainage volume (p < 0.05). However, the swelling of the knee was higher
on the 1st, 3rd, and 7th postoperative days (p < 0.05). Also, the first-side TKA scored lower in
satisfaction VAS, but higher in pain VAS at the 1st, 3rd,
and 7th postoperative days.
As per the patient satisfaction scores, 2 (4.4%) of the 46 patients
rated first-side TKA higher than second-side TKA, 34 (73.9%) of the 46 patients
rated second-side TKA higher than first-side TKA, and 10 (21.7%) of the 46
patients rated their satisfaction as the same for both knees.
Overall, there was better patient satisfaction with the
second knee in the early stage following simultaneous bilateral TKA. This may
supplement some considerations for surgeons opting for simultaneous bilateral
TKA for patients suffering from osteoarthritis in both
knees.
Journal of Orthopaedic Surgery and Research
Different patient satisfaction levels between the first and second knee in the early stage after simultaneous bilateral total knee arthroplasty (TKA): a comparison between subjective and objective outcome assessments
Shuai Huang et al.
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