title: Staged bilateral total knee arthroplasty: does history dictate the future?
abstract: A retrospective cohort study of 668 staged bilateral TKA patients was conducted to determine first-side versus second-side subjective and objective outcomes. Improvement in patient perceived function, measured by one-year Oxford Score (OKS) was defined by a minimal clinically important difference of >5 points in OKS. Results indicate that patients who had a minimal clinically important improvement (MCII) on the first-side have a significantly greater chance of maintaining or improving benefit with second-side TKA (OR 3.2; 95% CI 1.63-6.22; P=0.000). Of those with no clinical improvement (NCI), 71.4% achieved MCII on the second-side, while 28.6% remained NCI (P=0.000). Patients who do not initially benefit from first-side TKA should not be denied second-side staged-TKA as they still have a significant chance of achieving an MCII.
authors.affiliation: Hamilton Arthroplasty Group, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada.
authors.forename: Majdi
authors.initials: M
authors.lastname: Qutob
authors.forename: Mitch
authors.initials: M
authors.lastname: Winemaker
authors.forename: Danielle
authors.initials: D
authors.lastname: Petruccelli
authors.forename: Justin
authors.initials: J
authors.lastname: de Beer
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010147:Pain Measurement; D011183:Postoperative Complications / Q000453:epidemiology*; D020127:Recovery of Function; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: minimal clinically important difference; outcomes; staged bilateral total knee arthroplasty