Outcome of Simultaneous Bilateral Total Knee Replacement in Patients Compared to Unilateral Knee Replacement: A Comparative Study

Abstract

Background & Objectives: Joint replacement for the treatment of large joint arthritis has proven very successful.
Total Knee Replacement (TKR) improve mobility, reduces pain and overall positive effect on quality of life. With
changing trends in current orthopedics and a balance between patient satisfactions with cost effective procedures,
simultaneous bilateral TKR is gaining popularity. We aim to look at the outcome of simultaneous bilateral TKR in our
study
Methodology: We looked at TKAs performed at a private institution during a period of 3 years by one surgeon. Total 140
joints were replaced by Dr Muhammad Bilal during April 2021 to April 2024. Primary outcome measures were any need
for re-admission to hospital within 2 months and secondary complications such as infection, manipulation for stiffness,
revision, or any other procedure performed.
Results: Out of total 135 joint replaced, 61% (n=51/84) patients had Simultaneous Bilateral Knee Replacement while
39% (n=33/84) patients had one side knee replacement. Out of 84 patients, 64% (n=54) were females and 36% (n=30)
were male patients. Our primary outcome measures show none of the patients in either group needed re-admission
within 2 months after surgery. None of the patients developed stiffness or need for manipulation under anesthesia. One
patient in unilateral knee replacement group developed painful patella which was replaced, one patient developed
delayed infection and one patient developed peri prosthetic fracture.
Conclusion: Our study has clearly shown that simultaneous bilateral TKR group has better Patient reported Outcome
Measures (PROMs), low rate of infection, stiffness and anesthetic complications. Economically it has only one hospital
episode and lower overall costs. Patient selection criteria are not well defined yet but we recruited patients of 75 years
or younger, and fewer or at least well controlled associated medical conditions for simultaneous bilateral TKR.
Meticulous surgical technique, strict adherence to protocols and involvement of multi disciplinary team are of utmost
importance for higher success rates.