Dataset Information

No difference in the functional improvements between unilateral and bilateral total knee replacements.

ABSTRACT: BACKGROUND:Differences between staged bilateral total knee replacement (TKR) and simultaneous bilateral TKR have been investigated, but few studies have investigated differences in the functional improvements resulting from these methods. Therefore, this study investigates the different functional improvements between staged bilateral total knee TKR and simultaneous bilateral TKR. METHODS:Among 144 potential bilateral TKR patients who were included in this study, 93 (64.6%) patients selected unilateral TKR and 51 (35.4%) selected bilateral TKR. Functional improvements were assessed using the Western Ontario and McMaster University osteoarthritis index (WOMAC) and the Medical Outcomes Trust Short Form-36 (SF-36), and patients were interviewed pre-operatively and after 6 months. A generalized equation was used to test for differences in functional improvements. RESULTS:After TKR, pain, stiffness, function and total WOMAC scores were significantly reduced in both groups, with mean changes from -?26.6 to -?41.4 and from -?27.5 to -?42.2.The mean health change of SF-36 scores, physical component and mental component scores changed to 45.2?±?18.2, 74.0?±?15.4 and 77.0?±?9.6, respectively, in Group 1 and 47.1?±?17.1, 74.0?±?15.2 and 75.5?±?12.1, respectively, in Group 2. Unilateral and simultaneous bilateral TKR produce similar functional improvements, although current work status may be a novel impact factor. CONCLUSION:No differences in functional improvements were identified between patients who selected unilateral versus bilateral TKR, indicating no recommendation for one procedure over the other.

SUBMITTER: Huang YH

PROVIDER: S-EPMC5861654 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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No difference in the functional improvements between unilateral and bilateral total knee replacements.

Huang Yu-Hao YH Lin Chin C Yang Jia-Hwa JH Lin Leou-Chyr LC Mou Chih-Yuan CY Chiang Kwo-Tsao KT Lee Man-Gang MG Chang Hsien-Feng HF Chang Hsueh-Lu HL Su Wen W Yeh Shih-Jen SJ Chang Hung H Wang Chih-Chien CC Su Sui-Lung SL

BMC musculoskeletal disorders 20180321 1

<h4>Background</h4>Differences between staged bilateral total knee replacement (TKR) and simultaneous bilateral TKR have been investigated, but few studies have investigated differences in the functional improvements resulting from these methods. Therefore, this study investigates the different functional improvements between staged bilateral total knee TKR and simultaneous bilateral TKR.<h4>Methods</h4>Among 144 potential bilateral TKR patients who were included in this study, 93 (64.6%) patien ...[more]

PMID: 29562893

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Project description:BACKGROUND:Total knee replacement is a common operative procedure to improve pain, function, and quality of life in patients with end stage knee osteoarthritis. The current study aimed to compare simultaneous bilateral versus unilateral total knee replacement on pain intensity and recovery of function. METHODS:A total of 80 patients (bilateral 50, unilateral 30) aged 63.28 (9.4) years undergone total knee replacement participated in the current study. The participants were admitted for 5-7?days in the hospital. Participants in both the group received similar inpatient and outpatient physiotherapy sessions. Pain intensity and function capacity were assessed at baseline, day 7, and day 30 postoperatively using visual analogue scale and lower extremity functional scale, respectively. Repeated measures analysis of variance was used to analyze the data. RESULTS:Both groups showed a significant reduction of pain intensity (Day 0, mean 8.9, SD 1.0; Day 30, mean 2.2, SD 1.3 in bilateral total knee replacement; Day 0, mean 8.8, SD 1.1; Day 30, mean 2.0, SD 1.5 in unilateral total knee replacement; p <?0.001) and improvement in the functional capacity (Day 0, mean 16.2, SD 10.1; Day 30, mean 55.6, SD 14.6 in bilateral total knee replacement; Day 0, mean 19.1, SD 9.1; Day 30, mean 56.7, SD 15.8 in unilateral total knee replacement; p <?0.001) following total knee replacement at 30?days post-operatively. However, there was a non-significant difference noted between bilateral versus unilateral total knee replacement on the reduction of pain intensity (mean changes, 6.9 versus 6.8) and improvement in the functional capacity (mean changes, 39.4 versus 37.6) at 30?days post-operatively (p?>?0.05). CONCLUSION:Simultaneous bilateral total knee replacement was associated with a similar reduction of pain intensity and recovery of function compared to unilateral total knee replacement, suggesting the use of simultaneous bilateral total knee replacement in patients with bilateral knee osteoarthritis since its costs and rehabilitation process could be reduced compared to staged bilateral total knee replacement.

Project description:More robust preclinical experimental wear simulation methods are required in order to simulate a wider range of activities, observed in different patient populations such as younger more active patients, as well as to fully meet and be capable of going well beyond the existing requirements of the relevant international standards. A new six-station electromechanically driven simulator (Simulation Solutions, UK) with five fully independently controlled axes of articulation for each station, capable of replicating deep knee bending as well as other adverse conditions, which can be operated in either force or displacement control with improved input kinematic following, has been developed to meet these requirements. This study investigated the wear of a fixed-bearing total knee replacement using this electromechanically driven fully independent knee simulator and compared it to previous data from a predominantly pneumatically controlled simulator in which each station was not fully independently controlled. In addition, the kinematic performance and the repeatability of the simulators have been investigated and compared to the international standard requirements. The wear rates from the electromechanical and pneumatic knee simulators were not significantly different, with wear rates of 2.6?±?0.9 and 2.7?±?0.9?mm3/million cycles (MC; mean?±?95% confidence interval, p?=?0.99) and 5.4?±?1.4 and 6.7?±?1.5?mm3/MC (mean?±?95?confidence interval, p?=?0.54) from the electromechanical and pneumatic simulators under intermediate levels (maximum 5?mm) and high levels (maximum 10?mm) of anterior-posterior displacements, respectively. However, the output kinematic profiles of the control system, which drive the motion of the simulator, followed the input kinematic profiles more closely on the electromechanical simulator than the pneumatic simulator. In addition, the electromechanical simulator was capable of following kinematic and loading input cycles within the tolerances of the international standard requirements (ISO 14243-3). The new-generation electromechanical knee simulator with fully independent control has the potential to be used for a much wider range of kinematic conditions, including high-flexion and other severe conditions, due to its improved capability and performance in comparison to the previously used pneumatic-controlled simulators.

Dataset Information

No difference in the functional improvements between unilateral and bilateral total knee replacements.

Publications

No difference in the functional improvements between unilateral and bilateral total knee replacements.

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