Evidence map›Paper›PMID 35096536›Full record

ArticleWorld journal of orthopedics2022

Should we use similar perioperative protocols in patients undergoing unilateral and bilateral one-stage total knee arthroplasty?

Artit Laoruengthana, Piti Rattanaprichavej, Parin Samapath, Bhuwad Chinwatanawongwan, Pariphat Chompoonutprapa, Krit Pongpirul

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Article in World journal of orthopedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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0cells of the map it votes in
4citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

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3 · Its place in the literature

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4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Artit LaoruengthanaDepartment of Orthopaedics, Naresuan University, Mueang 65000, Phitsanulok, Thailand.
Piti RattanaprichavejDepartment of Orthopaedics, Naresuan University, Mueang 65000, Phitsanulok, Thailand. pt-rp@hotmail.com.
Parin SamapathDepartment of Orthopaedics, Naresuan University, Mueang 65000, Phitsanulok, Thailand.
Bhuwad ChinwatanawongwanDepartment of Orthopaedics, Naresuan University, Mueang 65000, Phitsanulok, Thailand.
Pariphat ChompoonutprapaDepartment of Orthopaedics, Naresuan University, Mueang 65000, Phitsanulok, Thailand.
Krit PongpirulDepartment of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBilateral one-stage total knee arthroplasty (BTKA) is now in greater use as an alternative option for patients with bilateral end-stage knee arthropathy. However, postoperative pain and disablement during convalescence from BTKA, and procedure-related complications have been concerning issues for patients and surgeons. Although some studies reported that BTKA in selected patients is as safe as the staged procedure, well-defined guidelines for patient screening, and perioperative care and monitoring to avoid procedure-related complications are still controversial.

aimTo compare the perioperative outcomes including perioperative blood loss (PBL), cardiac biomarkers, pain intensity, functional recovery, and complications between unilateral total knee arthroplasty (UTKA) and BTKA performed with a similar perioperative protocol.

methodsWe conducted a retrospective study on consecutive patients undergoing UTKA and BTKA that had been performed by a single surgeon with identical perioperative protocols. The exclusion criteria of this study included patients with an American Society of Anesthesiologists score > 3, and known cardiopulmonary comorbidity or high-sensitivity Troponin-T (hs-TnT) > 14 ng/L. Outcome measures included visual analogue scale (VAS) score of postoperative pain, morphine consumption, range of knee motion, straight leg raise (SLR), length of stay (LOS), and serum hemoglobin (Hb) and hs-TnT monitored during hospitalization.

resultsOf 210 UTKA and 137 BTKA patients, those in the BTKA group were younger and more predominately female. The PBL of the UTKA

conclusionFollowing similar perioperative management, the blood transfusion rate in BTKA is 4-fold that required in UTKA. Also, BTKA is associated with higher pain intensity at 48 h postoperatively and prolonged LOS when compared to the UTKA. Hence, BTKA patients may require more extensive perioperative management for blood loss and pain, even if having no higher risk of complications than UTKA.

Indexed as

Bilateral one-stage total knee arthroplastyBlood lossCardiovascular eventsHigh-sensitivity Troponin-TPostoperative painUnilateral total knee arthroplasty

Identifiers

PMID35096536
PMCPMC8771417

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