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Low complication rates seen with sequential, bilateral uni knee replacements
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MANCHESTER – Researchers from the United Kingdom found low complication rates after single-stage sequential, bilateral unicompartmental knee replacement, according to results of a recently presented study.
“Single-stage sequential, bilateral unicompartmental knee replacements can be performed safely with no major complications and significant benefits to all concerned,” senior author David Houlihan-Burne, FRCS (Orth), told Orthopaedics Today Europe.
“These benefits include a single hospital admission and anesthetic for the patient, a shorter total in-patient stay and enhanced rehabilitation when compared with having to mobilize one arthritic knee. This procedure achieves an overall shorter recovery period, with the achievement of a significant increase in function whilst also reducing overall costs for the hospital,” Houlihan-Burne said.
Focus on recovery
In the study, which was presented at the British Orthopaedic Association Congress, Houlihan-Burne and colleagues wanted to prove it was “safe, more convenient and cost-effective to perform surgery to both knees at one sitting, rather than having two separate admissions,” and to show that complication rates and readmissions would not increase with the single-stage procedure providing it is to be performed in the setting of a rapid recovery program.
They included 38 patients (22 women, 16 men) who underwent bilateral single-stage sequential unicompartmental total knee replacement done with the Oxford Partial Knee System (Biomet, Swindon, United Kingdom) between 2006 and 2010. Patients had a mean follow-up of 20 months and mean age of 64 years.
The researchers measured time to mobilization, average length of stay, preoperative and postoperative Oxford Knee Scores (OKS) and total tourniquet time.
Complication rate
Mean total tourniquet time was 83 minutes. The average time to mobilization was 18 hours, and patients had an average length of stay of 3.5 days. The mean complication rate was 3.9%, with two patients who needed excision of superficial suture granulomas. One patient needed fixation of a tibial plateau fracture due to a fall, and no patients had thromboembolic events or deep infections.
“No complications [were] related to the fact it was a single stage bilateral, but three complications [...] may have happened even if unilateral surgery was performed,” Houlihan-Burne said.
Future research will compare the functional results of these patients to those with both knees operated on at separate times, according to Houlihan-Burne.
“A single hospital admission and single period of recovery provided a quicker return to full function and work, preventing re-admission for the second side 3 months after the first,” he said. “It is important to note, most units perform this operation as two separate admissions increasing the social implications for the patient and costs to the hospital.” – by Renee Blisard Buddle
- Reference:
- Akhtar K. Paper #14. Presented at: British Orthopaedic Association Congress; Sept. 11-14, 2012; Manchester.
- For more information:
- David Houlihan-Burne, FRCS (Orth), can be reached at Bishops Wood Hospital, Rickmansworth Rd, Northwood, Middlesex HA6 2JW United Kingdom; email: dhbsurgery@googlemail.com.
Disclosure: Houlihan-Burne has received fees from Biomet and Corin for lecturing and teaching purposes.