TKR: Simultaneous bilateral vs. Unilateral

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TKR Simultaneous bilateral vs. Unilateral

• Simultaneous bilateral TKR
• 213 cases, 1986-1991
• Unilateral TKR
• 107 cases, 1986-1988
• Result
• Complication
• Knee function
• Simultaneous bilateral total knee replacement vs.
  unilateral replacement.. American Journal of
  Orthopedics,1996 Sep.

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Result

• Length of stay
• Bil. 9.6 days
• Uni. 9.2 days
• Operating time
• Bil 1.5 hours of 2 knees
• Uni.45 minutes

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Complication

• Complications
• Bil. 7.5 of the knees
• Uni. 11.2 of the knees
• Orthopedic complications
• Bil. 2.1
• Uni. 5.6

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Knee function
HSS Pre-op. HSS Post-op. Flexion Post-op.
Bilateral 60.6 93.6 114
Unilateral 63.5 93.4 115
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Special intraop. monitor of bil. TKR

• Pulmonary vascular resistance
• lt200dyne/second/cm5
• PVR/SVR ratio
• compared to baseline, increase lt60
• Intraoperative monitoring for safety of
  bilateral total knee replacement. Clinical
  Orthopaedics Related Research, 2002 Mar.

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Hemodynamic response after serial tourniquet
deflation 1
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Hemodynamic response after serial tourniquet
deflation 2
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