title: Severe Bilateral Fixed Flexion Deformity-Simultaneous or Staged Total Knee Arthroplasty?
abstract: Outcomes of 29 simultaneous (SimBTKA) and 38 staged bilateral total knee arthroplasty (StaBTKA) subjects with severe (≥16°) bilateral fixed flexion deformity (FFD) were retrospectively investigated. SimBTKA patients were significantly younger (63 ± 8 vs 68 ± 7, P > .01). At 2 years, SimBTKA subjects had significantly better residual FFD (2.5° ± 5.1° vs 5.4° ± 6.6°, P = .02) and Knee Society function score (75.7 ± 25.7 vs 69.3 ± 24.1, P = .02). However, Knee Society knee scores, Oxford Knee Scores, and Short Form-36 scores were similar. These suggest no large clinical advantage of SimBTKA over StaBTKA. We feel that severe bilateral FFD is not an absolute indication for SimBTKA.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors.forename: Wu Chean
authors.initials: WC
authors.lastname: Lee
authors.affiliation: Centre of Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Republic of Singapore; Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Republic of Singapore.
authors.forename: Yu Heng
authors.initials: YH
authors.lastname: Kwan
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors.forename: Seng Jin
authors.initials: SJ
authors.lastname: Yeo
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000601:surgery*; D007717:Knee / Q000002:abnormalities* / Q000033:anatomy & histology / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: bilateral flexion contracture; total knee arthroplasty