title: Influence of bilateral sequential total knee arthroplasty on functional recovery.
abstract: BACKGROUND
  Main concerns of patients undergoing bilateral surgery is the quantum of pain and the progress of functional recovery. We studied functional recovery in terms of pain, range of motion (ROM), SF12, WOMAC scores and a unique TUG (timed up and go) test for patients undergoing unilateral total knee arthroplasty (U/L-TKA) and sequential bilateral total knee arthroplasty (B/L-TKA).
  
  
  METHODS
  Three groups of 77 consecutive patients (91 knees) were retrospectively compared. They were B/L TKA group (28 knees: 14 patients), Unilateral TKA group with contralateral knee nonoperated i.e., U/L-TKA group (42 knees) and Unilateral TKA with contralateral TKA already done i.e., U/L + C/L TKA group (21 knees). Patients were assessed preoperatively and on postoperative days 3, 5, 14, 42, 90 and 1 year.
  
  
  RESULTS
  The WOMAC score was statistically better preoperatively in the U/L + C/L TKA group, and SF12 MCS score was statistically better preoperatively in the B/L-TKA group. The TUG test time in the B/L-TKA group was statistically longer on days 3 and 5 as compared to other groups and became comparable by day 14. The TUG score became better than the preoperative value by day 42 in the B/L-TKA group, which took 90 days in other groups.
  
  
  CONCLUSIONS
  The early functional recovery of bilateral TKA patient lags behind that of unilateral TKA patient for the first 5 days, becomes equal by the 14(th) day and remains equal till 1 year after surgery. Bilateral TKA patients regain their preoperative functional status by 6 weeks against 3 months for unilateral TKA. The operative status of the contralateral knee makes no difference to early functional recovery after unilateral TKA. With bilateral TKA, there is no difference in pain and ROM parameters.
authors.affiliation: Department of Orthopaedics, Lilavati Hospital and Research Centre, Bandra, India.
authors.forename: Rajesh N
authors.initials: RN
authors.lastname: Maniar
authors.forename: Jayesh V
authors.initials: JV
authors.lastname: Baviskar
authors.forename: Tushar
authors.initials: T
authors.lastname: Singhi
authors.forename: Parul
authors.initials: P
authors.lastname: Maniar
authors.forename: Ravi
authors.initials: R
authors.lastname: Nayak
keywords: Total knee arthroplasty; rehabilitation; timed up and go test