Outcome implications for the timing of bilateral total knee arthroplasties.
Combined meeting of the Knee Society and American Association of Hip and Knee Surgeons. San Francisco, USA, 1997/02.
Health Care Financing Administration data from 1985 to 1990 revealed 339,152 total knee arthroplasties of which 62,730 (18.6%) were bilateral procedures (simultaneous 112,922 ; staged 6 weeks, 4354 ; staged 3 months, 4524 ; staged 6 months, 9829 ; and staged 1 year 31,401).
Medicare beneficiaries undergoing bilateral procedures were an average of 73 years of age ; demographics revealed that among the various simultaneous and staged groups 57% to 69% were females, 90% were white, 85% to 90% had a diagnosis of osteoarthritis, and 30% to 40% were performed in rural hospitals.
Between 1985 and 1990, surgical and vascular complications ranged from 2.4% to 4% and 4.1% to 6.8%, respectively, for all types of bilateral staged and simultaneous total knee arthroplasties.
All differences were statistically significant.
After controlling statistically for demographic variables and diagnoses, a surrogate for case mix, it was found that individuals electing simultaneous bilateral arthroplasties experienced twice the number of intensive care days than those choosing staged procedures.
Days in the intensive care unit were double when done simultaneously instead of staged (0.48 versus 0.21).
Nosocomial infections were similar within groups (10% versus 13%) ; however, wound infections were nearly half when done simultaneously (0.5% versus 1%) versus in a staged fashion. (...)
Mots-clés Pascal : Plastie, Prothèse, Total, Genou, Membre inférieur, Bilatéral, Relation, Intervalle temps, Evolution, Complication, Etude comparative, Homme, Chirurgie, Système ostéoarticulaire pathologie, Arthropathie, Economie santé
Mots-clés Pascal anglais : Plasty, Prosthesis, Total, Knee, Lower limb, Bilateral, Relation, Time interval, Evolution, Complication, Comparative study, Human, Surgery, Diseases of the osteoarticular system, Arthropathy, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0053952
Code Inist : 002B25I. Création : 14/05/1998.