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Lower rates of infection, mechanical failure seen with simultaneous bilateral TKR
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Simultaneous bilateral total knee replacement results in significantly fewer prosthetic joint infections compared with staged procedures, according to results recently presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons.
However, the study revealed that simultaneous bilateral total knee replacement (TKR) carried a higher risk of adverse cardiovascular outcomes within 30 days of the procedure, according to an American Academy of Orthopaedic Surgeons (AAOS) press release.
“These findings indicate that performing simultaneous knee replacements would significantly reduce the incidence of major orthopedic complications and, at the same time, reduce the number of hospitalizations and the number of operating room sessions,” study investigator John P. Meehan, MD, stated in the release.
Meehan and colleagues used the California Patient Discharge Database to perform a retrospective comparison of adverse outcomes in 11,445 patients who underwent simultaneous bilateral TKR and 23,715 patients who had the first of two sequential or staged TKRs performed between 1997 and 2006.
The investigators discovered that patients who underwent simultaneous TKR had a 48% lower rate of major joint infection and a 26% lower rate of mechanical malfunction compared with the staged TKR group. However, the simultaneous group also displayed a 50% to 60% higher risk-adjusted odds of death, myocardial infarction or pulmonary embolism than the staged cohort.
“Our study found that the risk of developing a serious joint infection that required an additional knee revision surgery was two times higher in patients who had staged knee replacements compared to the patients who had both knees replaced at the same time — 2.2% after staged knee replacements and 1.2% after bilateral knee replacements,” Meehan stated in the release.
Further research is necessary to better define which patients should not be considered for bilateral simultaneous knee replacement, Meehan added.
Reference:
- Meehan JP, et al. Safety of simultaneous bilateral total knee arthroplasty (B-TKA) versus staged bilateral TKA (S-TKA). Paper 593. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 14-19, 2011. San Diego.
Disclosure: Meehan has reported no relevant financial disclosures.
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