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Comparison of time courses in postoperative functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty with propensity score matching

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction/objectives

No consensus has been reached on which is better in terms of functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty (TKA). As patient characteristics, such as age, sex, and body mass index, have significant effects on functional outcomes after TKA, these factors should be matched before comparisons are made. This study aimed to compare time courses in functional outcomes between simultaneous bilateral TKA and unilateral TKA after matching the patient characteristics.

Materials and methods

In this retrospective study, the clinical records of patients admitted to a hospital were reviewed. Of 425 patients, 43 underwent simultaneous bilateral TKA, whereas 382 underwent unilateral TKA. Propensity score matching was performed for age, sex, and body mass index between simultaneous bilateral and unilateral TKA patients. Therapists measured pain intensity, knee extensor strength, and knee-specific functional outcomes by using the new knee society score, including total score, symptoms, patient satisfaction, patient expectations, and functional activities preoperatively and 3 and 12 months postoperatively. Two-way repeated analysis of variance was performed to compare the time courses in functional outcomes between simultaneous bilateral and unilateral TKA.

Results

After propensity score matching, 40 patients each for underwent bilateral TKA and unilateral TKA were selected. Knee extensor strength in simultaneous bilateral TKA patients was significantly lower than that in unilateral TKA patients at 3 months postoperatively (p = 0.04). A significant interaction was observed between the effects of time and group on knee extensor strength (F [1, 78] = 3.338; interaction: p = 0.042; η2 = 0.052). No significant interactions were found among the other variables measured.

Conclusions

Patients who underwent simultaneous bilateral TKA should undergo postoperative rehabilitation focused on alleviating delayed recovery in knee extensor strength during the acute phase.

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Data availability

The datasets generated during and/or analyzed during the present study are available from the corresponding author on reasonable request.

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Acknowledgements

We acknowledge all subjects and staff members who participated in this study.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Rehabilitation Science, Osaka Health Science University, 1-9-27, Tenma, Kita-ku, Osaka, 530-0043, Japan

    Tomohiro Oka

  2. Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe City, Hyogo, Japan

    Tomohiro Oka

  3. Department of Rehabilitation, Anshin Hospital, 1-4-12, Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, Japan

    Osamu Wada

  4. Department of Orthopedics, Anshin Hospital, 1-4-12, Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, Japan

    Kiyonori Mizuno

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Contributions

TO and OW helped in the research idea and study design. TO and KM acquired data. TO, OW, and KM were involved in data analysis and interpretation. TO was involved in statistical analysis. OW and KM were involved in supervision or mentorship. Each author contributed important intellectual content during article drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Tomohiro Oka.

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Conflict of interest

The authors have no competing interests to disclose.

Ethical approval

The ethics committee of our hospital approved the study protocol before commencement of the study (approval protocol number: No. 60; December 2020).

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All participants provided written informed consent in accordance with the Declaration of Helsinki.

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Oka, T., Wada, O. & Mizuno, K. Comparison of time courses in postoperative functional outcomes between simultaneous bilateral and unilateral total knee arthroplasty with propensity score matching. Arch Orthop Trauma Surg 144, 369–375 (2024). https://doi.org/10.1007/s00402-023-05065-9

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  • DOI: https://doi.org/10.1007/s00402-023-05065-9

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