Outcomes of bilateral simultaneous primary total knee arthroplasty with tibial stems or revision implants

Abstract

Background: Total knee arthroplasty (TKA) is effective for alleviating pain and restoring function in end-stage arthritis. Simultaneous bilateral TKA (simBTKA) offers benefits such as a single anesthetic, lower costs, and enhanced joint rehabilitation.
Objective: This study aimed to assess the outcomes of simBTKA using patient-specific templating (PST) in patients with unilateral tibial stem or revision implants.
Patients and Methods: Data were prospectively collected through the Egyptian Community Arthroplasty Registry. The study included 120 patients with severe bilateral osteoarthritis who underwent simBTKA with PST. Exclusion criteria included unicompartmental, revision, and bilateral knee replacements without tibial stems. Knee Society Score (KSS) and range of motion (ROM) outcomes were compared between groups using Student’s t-test.
Results: The cohort was predominantly female (75%) with a mean age of 65.1 years. There was a significant age difference between the groups (P = 0.026), but no differences in preoperative varus (P = 0.085) or fixed flexion deformities (P = 0.185). No mortality was recorded. Improvement in KSS (P = 0.711) and ROM (P = 0.270) was comparable between groups. Complications were reported in seven patients, with the most severe being a superficial infection requiring debridement and polyethylene exchange.
Conclusion: Tibial stems or revision implants in simBTKA result in satisfactory improvements in KSS and ROM, further supporting the advantages of simBTKA, particularly with PST or similar patient-specific instrumentation.