title: Functional Outcomes of the Second Surgery Are Similar to the First in Asians Undergoing Staged-Bilateral Total Knee Arthroplasty.
abstract: BACKGROUND
  Patients suffering from bilateral knee osteoarthritis often require bilateral total knee arthroplasty (TKA) to alleviate symptoms. There is controversy surrounding the approach to the surgical treatment of such patients. We asked if Asian patients undergoing staged-bilateral TKA had any difference in their short-term functional outcomes, comparing the first TKA to the second one and if the interval between the 2 surgeries had any impact of functional outcomes.
  
  
  METHODS
  We identified 100 patients from a single surgeon from 2006 to 2010 who had staged-bilateral TKA and had at least 2 years of follow-up for each TKA. The time interval between the first and second TKA ranged from 6 months to 1 year. Range of motion, Oxford knee questionnaire scores, knee scores and function scores at 6 months and 2 years of follow-up were then compared between the first and second TKA using the Student's T-test.
  
  
  RESULTS
  Although length of stay was reduced and time to ambulation was shorter for the second TKA, there were no significant differences in functional outcomes at 2 years. There was also no difference in outcome when patients were stratified according to time interval between TKAs.
  
  
  CONCLUSIONS
  Staged-bilateral TKA continues to be a good option for patients presenting with severe bilateral knee osteoarthritis. The second arthroplasty has similar functional outcomes as the first arthroplasty. Our results can be used in preoperative counselling of patients undergoing staged-bilateral TKA.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore.
authors.forename: Vijay
authors.initials: V
authors.lastname: Kumar
authors.forename: Hamid Rahmatullah
authors.initials: HR
authors.lastname: Bin Abd Razak
authors.forename: Hwei Chi
authors.initials: HC
authors.lastname: Chong
authors.forename: Andrew Hc
authors.initials: AH
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D044466:Asian People; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012846:Singapore; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking