Abstract
Introduction
The aim of this study was to compare the outcome between the first and second knee replacement in patients undergoing staged bilateral total knee arthroplasty.
Methods
A prospective database of outcomes of knee replacements performed at Broadgreen Hospital was commenced in 2003. Data is collected pre operatively, 3 and 12 months post operatively and every two years thereafter. We identified 64 patients (26 male, 38 female) who had bilateral knee replacements and had at least one year post operative outcome studies. Data on pain scores, walking ability (score 1-6), use of walking aids (score 1-6), range of movement, instability, muscle strength, WOMAC scores, SF-12 scores, the Knee Society Radiological Score and length of hospital stay were identified. We compared data between the first and second knee operation.
Results
Groups remained statistically comparable between the 1st and 2nd operation. Average score for post op walking ability was 4.83 (2nd knee) vs 4.51 (1st knee) (p=0.03). Average score for post op walking aid requirement was 5.73 (2nd knee) vs 5.46 (1st knee) (p=0.01). Patient's post op SF-12 scores were 54.26 (2nd knee) vs 52.45 (1st knee) (p=0.04). Average hospital stay was 4.73 (2nd Knee) vs 6.06 (1st knee) (p=0.05). All other data comparison was statistically insignificant.
Conclusion
Patients have reduced hospital stay and continue to improve after the second procedure with regards to walking ability, use of walking aids and psychological well being. This may be because having the worst knee replaced first means improved walking ability and decreased need for walking aids after the second operation. Also patients have already experienced one knee replacement and therefore are less apprehensive and more familiar with the post operative physiotherapy and rehabilitation programme.
