Prednosti i rizici bilateralnih artroplastika kolena u jednom aktu

Abstract

Introduction: Gonarthrosis in a certain number of cases requires surgical treatment – knee arthroplasty. Bilateral gonarthrosis is a common finding. Patients with bilateral gonarthrosis can be operated in one procedure, during one course of a hospital stay, which may have significant advantages over delayed procedure. Bilateral knee arthroplasty in one procedure is routinely performed in some orthopedic centers, and in other, due to potentially higher risks of this approach, patients are operated in two surgical procedures with various time intervals between two arthroplasties. The aim of the study is to determine the advantages and risks of bilateral knee arthroplasty in one procedure in relation to bilateral total knee arthroplasty in two procedures. The aim was to determine the benefits and risks of bilateral knee arthroplasty in one act in relation to bilateral total knee arthroplasty in two acts. Methods: Retrospective study, in the first group, 256 patients of both gender, who had bilateral total knee arthroplasty in one act in the Department of Orthopaedic Surgery and Traumatology, Military Medical Academy in Belgrade from 01. january 2004. to 31. december 2011. year, in the second group were 165 patients who had bilateral total knee arthroplasty in two acts in the same department and in the same period. In all cases, an identical surgical approach and technique was used, with the standard antibiotic prophylaxis and thromboprophylaxis with low-molecular weight heparins. We assessed the risk of postoperative mortality, complications, functional outcome, the need for transfusions, and length of hospital stay. Results: This analysis shows that in the examined groups of patients, SBTKA and BTKA in two acts, who had no significant differences in the presence of preoperative comorbidity and age, there were no statistically significant differences in postoperative 30-day mortality, postoperative complications, infections and revision surgery. When it comes to the assessment of the functional outcome and length of hospital stay SBTKA shows significantly better results compared to BTKA in two acts. 7 Conclusion: Results of this study show that SBTKA even in patients with recorded preoperative comorbidities can be safe and successful procedure with acceptable low incidence of postoperative complications.