Clinical outcomes after simultaneous bilateral total knee arthroplasty: comparison to unilateral total knee arthroplasty and healthy controls

Abstract

The purpose of this study was to evaluate the functional outcomes of persons who underwent simultaneous bilateral total knee arthroplasty (TKA) compared to subjects who underwent unilateral TKA and a healthy control group. Fifteen subjects who underwent primary bilateral TKA and 15 sex, age, and body mass index-matched subjects who underwent primary unilateral TKA were observed prospectively for 2 years. Subjects in both surgical groups showed significant improvement in Knee Outcome Scores, Short Form 36 physical component scores, Timed Up and Go, and stair-climbing tasks (P <or= .004). No differences in final outcomes were found between surgical groups. In addition, most 2-year clinical measures were no different between the surgical and control groups. Subjects medically appropriate for bilateral TKA should be afforded this option.

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Figures

Fig. 1

Subjects in the unilateral group showed a significant increase in BMI at the 2-year follow-up when compared to the preoperative values (P = .003). Both the bilateral TKA and unilateral TKA group had higher BMIs at preoperative and 2-year follow-up (P ≤ .028).

Fig. 2

Although the bilateral and unilateral groups showed a significant increase in KOS grades from initial evaluation to 2-year follow-up (asterisk) (P < .001), a significant difference existed in the KOS values between the bilateral and the control group (asterisk) (P = .003). No differences existed between either of the surgical groups at any of the periods.

Fig. 3

Significant increases in the PCS were seen for the bilateral and unilateral TKA groups (asterisk) (P < .001). No significant differences existed between either of the surgical groups or the control group at the 2-year follow-up.

Fig. 4

Persons in the bilateral and unilateral TKA groups showed a significant reduction in TUG times at the 2-year follow-up. There were no differences between any of the groups at the final follow-up (P = .20).

Fig. 5

Statistically significant and clinically meaningful decreases in the time for the SCT were seen in both of the surgical groups (asterisk) (P < .001). At 2 years after the surgery, these values were not significantly different than the times noted in the control group (P = .13).