The timing of performing knee arthroplasties in bilateral osteoarthritic knees remains controversial. Our aim was to compare one-stage with two-stage bilateral knee arthroplasties (TKA).

Between November 2004 and April 2008, 128 patients (72 female and 56 male) underwent one-stage bilateral TKAs. Another group of 115 patients that underwent two-stage procedures during the same period formed the control group. All patients received the same type of anaesthesia. Study parameters included age, weight, medical co-morbidities, length of hospital stay, blood loss, post-operative complications and functional outcome.

There were no significant differences between the two groups. Co-morbidities and functional outcome based on the Knee Society Score were similar in both groups. In the one-stage group the length of hospital stay and blood losses were higher than the two-stage group; however less than double compared to the two-stage group. The early post-operative complications were higher but not statistically significant in the one-stage group.

Despite the fact that the early post-operative complications are slightly higher in the one-stage group, this particular method is an effective way of dealing with bilaterally osteoarthritic knees. It offers excellent functional outcome at a reduced cost

The evaluation of results following posterior decompression and fusion for the management of cervical spondylotic myelopathy

Between July 2006 and May 2008, 68 patients with cervical myelopathy underwent posterior decompression with laminectomies and pedicle screw fixation of the cervical spine. All patients were selected based on the presence of multi-level degenerative disease and the correction of cervical lordosis on the pre-operative dynamic radiographs. Patient demographics, co-morbidities and post-operative complications were recorded and analysed. Functional outcome was assessed by using the Japanese Orthopaedic Association (JOA) score.

There were 37 male and 31 female patients with an average age 67.4 years. The average follow up period was 18 months. The mean pre-operative JOA score was 8.7, whereas the mean post-operative score was 12.1 on the latest follow-up visit. 9 patients had unsatisfactory clinical results and consequently underwent anterior procedures with significant improvement. Complications included 1 epidural haematoma, 2 superficial infections and 4 cases of myofascial pain. In three cases there was mild dysfunction of the C5 nerve root which resolved spontaneously with conservative measures.

In the present series of patients posterior decompression with laminectomies is an effective method for the management of cervical spondylotic myelopathy.