BACKGROUND: Proper sizing of femoral and tibial components has been associated with long-term outcomes and survivorship in simultaneous bilateral total knee arthroplasty (SBTKA) and may be a reason for differences in outcomes between knees. The aim of this study compares post-operative outcomes and revision rates in patients undergoing SBTKA with different component sizes. METHODS: A retrospective review was conducted at a single academic institution identifying patients who underwent SBTKA from 2011 to 2019. Inclusion criteria included: primary osteoarthritis, similar pre-operative deformity, and same implant manufacturer. The primary outcome compares pre- and post-op (delta, Δ) Knee Society Score-Knee Score (KSS-KS) and range of motion (ROM) between knees. Secondary outcome measures were all-cause revisions rates, including manipulations under anesthesia and arthroscopy with or without lysis of adhesions. RESULTS: 149 patients were identified who met the inclusion criteria: 128 patients had femoral size difference (FSD) of 0, 138 patients had tibial size difference (TSD) of 0, 21 patients with FSD of 1, and 11 patients with TSD of 1. There was no difference in ΔKSS-KS or ΔROM in patients for any FSD or TSD. Revisions for aseptic loosening were greater for TSD 1 compared to TSD 0 (p < 0.001). No other differences in cause of revision were identified. CONCLUSION: A TSD of 1 may be associated with increased revision rates for aseptic loosening in both smaller and larger sized implants. Surgeons may achieve optimal patient outcomes in SBTKA with proper sized implants through increased awareness of component asymmetry and repeat intraoperative evaluation when asymmetrical measurements occur.
BACKGROUND: Proper sizing of femoral and tibial components has been associated with long-term outcomes and survivorship in simultaneous bilateral total knee arthroplasty (SBTKA) and may be a reason for differences in outcomes between knees. The aim of this study compares post-operative outcomes and revision rates in patients undergoing SBTKA with different component sizes. METHODS: A retrospective review was conducted at a single academic institution identifying patients who underwent SBTKA from 2011 to 2019. Inclusion criteria included: primary osteoarthritis, similar pre-operative deformity, and same implant manufacturer. The primary outcome compares pre- and post-op (delta, Δ) Knee Society Score-Knee Score (KSS-KS) and range of motion (ROM) between knees. Secondary outcome measures were all-cause revisions rates, including manipulations under anesthesia and arthroscopy with or without lysis of adhesions. RESULTS: 149 patients were identified who met the inclusion criteria: 128 patients had femoral size difference (FSD) of 0, 138 patients had tibial size difference (TSD) of 0, 21 patients with FSD of 1, and 11 patients with TSD of 1. There was no difference in ΔKSS-KS or ΔROM in patients for any FSD or TSD. Revisions for aseptic loosening were greater for TSD 1 compared to TSD 0 (p < 0.001). No other differences in cause of revision were identified. CONCLUSION: A TSD of 1 may be associated with increased revision rates for aseptic loosening in both smaller and larger sized implants. Surgeons may achieve optimal patient outcomes in SBTKA with proper sized implants through increased awareness of component asymmetry and repeat intraoperative evaluation when asymmetrical measurements occur.
Authors: Christian Ries; Markus Heinichen; Florian Dietrich; Eike Jakubowitz; Christian Sobau; Christian Heisel Journal: Clin Orthop Relat Res Date: 2012-10-05 Impact factor: 4.176
Authors: Simon G F Abram; Andrew G Marsh; Alistair S Brydone; Fiona Nicol; Aslam Mohammed; Simon J Spencer Journal: Knee Date: 2014-06-02 Impact factor: 2.199
Authors: Christopher J L Murray; Charles Atkinson; Kavi Bhalla; Gretchen Birbeck; Roy Burstein; David Chou; Robert Dellavalle; Goodarz Danaei; Majid Ezzati; A Fahimi; D Flaxman; Sherine Gabriel; Emmanuela Gakidou; Nicholas Kassebaum; Shahab Khatibzadeh; Stephen Lim; Steven E Lipshultz; Stephanie London; Michael F MacIntyre; A H Mokdad; A Moran; Andrew E Moran; Dariush Mozaffarian; Tasha Murphy; Moshen Naghavi; C Pope; Thomas Roberts; Joshua Salomon; David C Schwebel; Saeid Shahraz; David A Sleet; Jerry Abraham; Mohammed K Ali; Charles Atkinson; David H Bartels; Kavi Bhalla; Gretchen Birbeck; Roy Burstein; Honglei Chen; Michael H Criqui; Eric L Ding; E Ray Dorsey; Beth E Ebel; Majid Ezzati; S Flaxman; A D Flaxman; Diego Gonzalez-Medina; Bridget Grant; Holly Hagan; Howard Hoffman; Nicholas Kassebaum; Shahab Khatibzadeh; Janet L Leasher; John Lin; Steven E Lipshultz; Rafael Lozano; Yuan Lu; Leslie Mallinger; Mary M McDermott; Renata Micha; Ted R Miller; A A Mokdad; A H Mokdad; Dariush Mozaffarian; Mohsen Naghavi; K M Venkat Narayan; Saad B Omer; Pamela M Pelizzari; David Phillips; Dharani Ranganathan; Frederick P Rivara; Thomas Roberts; Uchechukwu Sampson; Ella Sanman; Amir Sapkota; David C Schwebel; Saeid Sharaz; Rupak Shivakoti; Gitanjali M Singh; David Singh; Mohammad Tavakkoli; Jeffrey A Towbin; James D Wilkinson; Azadeh Zabetian; Jerry Abraham; Mohammad K Ali; Miriam Alvardo; Charles Atkinson; Larry M Baddour; Emelia J Benjamin; Kavi Bhalla; Gretchen Birbeck; Ian Bolliger; Roy Burstein; Emily Carnahan; David Chou; Sumeet S Chugh; Aaron Cohen; K Ellicott Colson; Leslie T Cooper; William Couser; Michael H Criqui; Kaustubh C Dabhadkar; Robert P Dellavalle; Daniel Dicker; E Ray Dorsey; Herbert Duber; Beth E Ebel; Rebecca E Engell; Majid Ezzati; David T Felson; Mariel M Finucane; Seth Flaxman; A D Flaxman; Thomas Fleming; Mohammad H Forouzanfar; Greg Freedman; Michael K Freeman; Emmanuela Gakidou; Richard F Gillum; Diego Gonzalez-Medina; Richard Gosselin; Hialy R Gutierrez; Holly Hagan; Rasmus Havmoeller; Howard Hoffman; Kathryn H Jacobsen; Spencer L James; Rashmi Jasrasaria; Sudha Jayarman; Nicole Johns; Nicholas Kassebaum; Shahab Khatibzadeh; Qing Lan; Janet L Leasher; Stephen Lim; Steven E Lipshultz; Stephanie London; Rafael Lozano; Yuan Lu; Leslie Mallinger; Michele Meltzer; George A Mensah; Catherine Michaud; Ted R Miller; Charles Mock; Terrie E Moffitt; A A Mokdad; A H Mokdad; A Moran; Mohsen Naghavi; K M Venkat Narayan; Robert G Nelson; Casey Olives; Saad B Omer; Katrina Ortblad; Bart Ostro; Pamela M Pelizzari; David Phillips; Murugesan Raju; Homie Razavi; Beate Ritz; Thomas Roberts; Ralph L Sacco; Joshua Salomon; Uchechukwu Sampson; David C Schwebel; Saeid Shahraz; Kenji Shibuya; Donald Silberberg; Jasvinder A Singh; Kyle Steenland; Jennifer A Taylor; George D Thurston; Monica S Vavilala; Theo Vos; Gregory R Wagner; Martin A Weinstock; Marc G Weisskopf; Sarah Wulf Journal: JAMA Date: 2013-08-14 Impact factor: 56.272