Abstract
Purpose
Overall outcome of bilateral hip and knee arthroplasty in the same patient with special regard to scheduling, postoperative complications and follow-up under consideration of the underlying disease.
Method
More than 6000 primary THA and 5500 primary TKA were implanted at Schulthess Clinic since 1985, 8% of which in rheumatoid patients. Quadruple THA and TKA was performed in a total of 51 rheumatoid patients. Mean follow-up for knees was 8. 5 years (1–17), and 9. 5 years (1–18) for hips. 67% of implants were uncemented. In 21% of patients, all four prostheses were implanted within one year and in over 50% within a five year period.
Results
Taking revision of components as failure there were three infections (CLS hip, GSB and LCS knee), two aseptic loosenings (Endler cup, GSB knee), two recurrent hip dislocations, three knee bearing exchanges (LCS, INNEX), and four patella component removals (GSB, PCA).
Conclusion
Quadruple arthroplasty in the lower extremity showed no increase of failure rate compared to single or dual arthroplasty patients. The results of this study support the indication for quadruple procedure with early postoperative rehabilitation and full weight bearing. Data suggest a procedure with hips before knees and at least two weeks between arthroplasty operations.
