Prognostic Factors in Staged Bilateral Total Knee Arthroplasty - A Retrospective Case Series Analysis

Background: Bilateral osteoarthritis of the knee is an indication for a bilateral total knee replacement (TKR) procedure. The goal of our study was to assess the sizes of the implants used during the first and second stages of TKR procedures in order to compare their size and identify the prognostic factors for the second procedure. Methods: We evaluated 44 patients who underwent staged bilateral TKR procedures. We assess the following prognostic factors from the first and second surgery: duration of anesthesia, femoral component size, tibial component size, duration of hospital stay, tibial polyethylene insert size, and the number of complications. Results: All assessed prognostic factors did not differ statistically between the first and second TKR. A strong correlation was found between the size of femoral components and the size of tibial components used during the first and second total knee arthroplasty. The mean duration of the hospital stay associated with the first TKR surgery was 6.43 days, whereas the mean duration of the second hospital stay was 5.5 days (p = 0.211). The mean sizes of the femoral components used during the first and second procedures were 5.43 and 5.2, respectively (p = 0.54). The mean sizes of the tibial components used during the first and second TKR procedures were 5.36 and 5.25, respectively (p = 0.382). The mean sizes of the tibial polyethylene inserts used during the first and second procedures were 9.45 and 9.34 (p = 0.422), respectively. The mean duration of anesthesia during the first and second knee arthroplasty was 117.04 min and 118.06 min, respectively (p = 0.457). The mean rates of recorded complications associated with the first and second TKR procedures were 0.13 and 0.06 per patient (p = 0.371). Conclusions: We observed no differences between the two stages of treatment in terms of all analyzed parameters. We observed a strong correlation between the size of femoral components used during the first and second total knee arthroplasty. We noted a strong correlation between the size of tibial components used during the first and second procedure. Slightly weaker prognostic factors include the number of complications, duration of anesthesia and tibial polyethylene insert size.