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Brief CommunicationBrief Communication
Open Access

Clinical outcomes of simultaneous bilateral total knee arthroplasty.

A tertiary-center experience

Abdullah O. Bawazir, Hossein A. Filimban, Nawaf Halabi, Salman W. Bafageeh, Rayan Halabi, Saeed Albukhari, Eyad A. Alakkas, Habib Al Etani, Abdullah Basalaim, Ahmed Alturkistan and Bander Hetaimish
Saudi Medical Journal March 2022, 43 (3) 317-320; DOI: https://doi.org/10.15537/smj.2022.43.3.20210903
Abdullah O. Bawazir
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MS
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Hossein A. Filimban
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MS
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Nawaf Halabi
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MS
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Salman W. Bafageeh
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MS
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Rayan Halabi
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MS
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Saeed Albukhari
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MS
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Eyad A. Alakkas
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MBBS, SBOS
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Habib Al Etani
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MD, FRCSC
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Abdullah Basalaim
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MD, FRCSC
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Ahmed Alturkistan
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MD, FRCSC
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Bander Hetaimish
From the College of Medicine (Bawazir, Filimban, N. Halabi, Bafageeh, Albukhari), King Saud Bin Abdulaziz University for Health Sciences, from the College of Medicine (R. Halabi), King Abdulaziz University, from the Department of Surgery/Orthopedic Section (Alakkas, Al Etani, Basalaim, Alturkistan), King Faisal Specialist Hospital and Research Center, and from the Orthopedic Surgery Department (Hetaimish), College of Medicine, University of Jeddah, Jeddah, Kingdom of Saudi Arabia.
MSc, FRCS
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    Table 1

    - Preoperative data (N=469).

    Demographicsn (%)
    Age (years)64 (58-70)
    Female393 (83.8)
    Males76 (16.2)
    BMI (kg/m2)34.6 (31-39.1)
    Smokers12 (2.6)
    Comorbidities
    Diabetes mellitus183 (39.0)
    Hypertension264 (56.3)
    Cardiac disease50 (10.7)
    Renal disease13 (2.8)
    Rheumatoid arthritis26 (5.5)
    Osteoporosis13 (2.8)
    Indications for surgery
    Primary osteoarthritis454 (96.8)
    Post-traumatic osteoarthritis3 (0.6)
    Preoperative diagnosis of rheumatoid arthritis26 (5.5)
    Arthritis secondary to still disease1 (0.2)

    Continuous data are presented as median (Q1-Q3) and categorical data as number and percentages (%).

      • View popup
      Table 2

      - Operative and postoperative data (N=469).

      Operative datan (%)
      Duration of surgery (minutes)155 (140-175)
      Duration of right tourniquet (minutes)49 (42-57)
      Duration of left tourniquet (minutes)45 (41-50)
      Postoperative data
      Hospital stay (days)9 (8-11)
      Blood loss (ml)140 (100-250)
      Revision of surgery17 (3.6)
      Revision of surgery time (days)265 (112-529)
      Complications
      Need blood transfusion104 (22.1)
      ICU admission6 (1.3)
      Intraoperative bleeding2 (0.4)
      Intraoperative fracture2 (0.4)
      Postoperative wound healing problem3 (0.6)
      Postoperative infection3 (0.6)
      Postoperative stiff joint1 (0.2)
      Postoperative persistent pain9 (1.9)
      Postoperative joint instability1 (0.2)
      Postoperative hematoma2 (0.4)
      Postoperative stroke1 (0.2)
      Postoperative bilateral knee laxity1 (0.2)
      Post operation right patellar Clunk syndrome1 (0.2)
      Post operation left patellar Clunk syndrome4 (0.9)
      Postoperative patellar dislocation2 (0.4)
      Postoperative periprosthetic fracture2 (0.4)
      Postoperative synovitis2 (0.4)
      Postoperative pulmonary embolism3 (0.6)
      Postoperative hemarthrosis1 (0.2)
      Complications132 (28.1)

      Continuous data are presented as median (Q1-Q3) and categorical data as number and percentages (%).

        • View popup
        Table 3

        - Factors affecting hospital stay

        FactorsCoefficient (95% CI)P-value
        Age0.001 (-0.03 - 0.004)0.69
        Male0.11 (0.02 - -0.19)0.01
        Body mass index0.004 (-0.001 - 0.008)0.10
        Diabetes mellitus0.06 (-0.004 - 0.13)0.07
        Hypertension-0.06 (-0.13 - 0.01)0.08
        Cardiac disease0.12 (0.02 - 0.21)0.02
        Renal disease0.23 (0.06 - 0.39)0.01
        Rheumatoid arthritis0.02 (-0.12 - 0.16)0.77
        Osteoporosis0.08 (-0.1 - 0.23)0.39

        CI: confidence interval

          • View popup
          Table 4

          - Factors affecting complications

          FactorsOR (95% CI)P-value
          Age1.01 (0.98 - 1.04)0.49
          Gender0.89 (0.49 - 1.61)0.69
          Body mass index1.02 (0.99 - 1.05)0.32
          Diabetes mellitus1.29 (0.81 - 2.05)0.28
          Hypertension1.35 (0.84 - 2.17)0.22
          Cardiac disease2.25 (1.19 - 4.24)0.01
          Renal disease0.74 (0.2 - 2.8)0.66
          Rheumatoid arthritis1.14 (0.42 - 3.11)0.79
          Osteoporosis2.48 (0.79 - 7.72)0.12

          OR: odd ratio CI: confidence interval

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          Saudi Medical Journal: 43 (3)
          Saudi Medical Journal
          Vol. 43, Issue 3
          1 Mar 2022
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          Clinical outcomes of simultaneous bilateral total knee arthroplasty.
          Abdullah O. Bawazir, Hossein A. Filimban, Nawaf Halabi, Salman W. Bafageeh, Rayan Halabi, Saeed Albukhari, Eyad A. Alakkas, Habib Al Etani, Abdullah Basalaim, Ahmed Alturkistan, Bander Hetaimish
          Saudi Medical Journal Mar 2022, 43 (3) 317-320; DOI: 10.15537/smj.2022.43.3.20210903

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          Clinical outcomes of simultaneous bilateral total knee arthroplasty.
          Abdullah O. Bawazir, Hossein A. Filimban, Nawaf Halabi, Salman W. Bafageeh, Rayan Halabi, Saeed Albukhari, Eyad A. Alakkas, Habib Al Etani, Abdullah Basalaim, Ahmed Alturkistan, Bander Hetaimish
          Saudi Medical Journal Mar 2022, 43 (3) 317-320; DOI: 10.15537/smj.2022.43.3.20210903
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          Keywords

          • simultaneous bilateral knee arthroplasty
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