Comparison of early effectiveness and safety of simultaneous and staged bilateral unicompartmental knee arthroplasty for bilateral anteromedial compartment osteoarthritis

Objective: To compare the early effectiveness and safety of simultaneous bilateral and staged bilateral unicompartmental knee arthroplasty (UKA) in treatment of anteromedial compartment osteoarthritis. 方法: 回顾性分析 2015 年 1 月—2017 年 1 月完成双侧 UKA 的 31 例双膝前内侧骨关节炎患者临床资料。其中，17 例行同期双膝 UKA（同期组），14 例行分期 UKA（分期组）。两组患者性别、年龄、体质量指数、骨关节炎分级以及术前髋-膝-踝角、膝关节学会评分系统（KSS）评分、疼痛视觉模拟评分（VAS）、膝关节活动度等一般资料比较，差异均无统计学意义（ P>0.05）。记录手术时间、出血量、住院时间、术后 10 d 内血红蛋白最低值及住院费用，分期组以两次手术总和进行比较。术后 3、6、12 个月，采用 KSS 评分、VAS 评分、膝关节活动度评价手术疗效，并记录术后 12 个月患者满意度评分。. Results: The operation time, hospitalization stay, and hospitalization cost of the simultaneous group were significantly lower than those of the staged group ( P 0.05). Superficial infection occurred in 1 side of 1 case (7.1%) in staged group. Postoperative delirium occurred in 1 case (5.9%) in simultaneous group. There was no significant difference in incidence of postoperative complications between the two groups ( P=1.000). Patients in both groups were followed up 12-32 months (mean, 24.7 months). There was no significant difference in KSS score between the two groups at 3 months after operation ( t=0.896, P=0.392). KSS scores were significanly higher in simultaneous group than in staged group at 6 and 12 months after operation ( P 0.05). At 12 months after operation, the patient satisfaction scores were significantly higher in simultaneous group than in staged group ( P<0.05). X-ray films showed no loosening of the prosthesis in the two groups. Conclusion: Simultaneous bilateral UKAs has the same security as staged bilateral UKAs. Meanwhile knee function recovery was better, hospitalization stay and hospitalization cost reduced, and patient satisfaction was higher in simultaneous bilateral UKAs.