Authors (including presenting author) :
Poon CMY(1), Louie FTM(2), Chan KCY(2), Yau DLY(2)
Affiliation :
(1)Occupational Therapy Department, Tai Po Hospital, (2)Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital, Hong Kong
Introduction :
In 2018, around 36% of TKR performed were same-stage bilateral total knee replacement (SBTKR) in Alice Ho Miu Ling Nethersole Hospital Joint Replacement Centre (AHNH-JRC). Previous literatures have reported its benefits but still a controversy that simultaneous knee surgeries would make rehabilitation more difficult compared with unilateral procedures.
Objectives :
To investigate Activity of Daily Living (ADL) recovery and knee functions of patients with SBTKR versus UTKR.
Methodology :
Patients with bilateral knee osteoarthritis with TKR operated from January 2017 to June 2018 were reviewed retrospectively. All patients undergo multidisciplinary perioperative care and postoperative rehabilitation in AHNH-JRC with well-designed protocol. Occupational Therapy (OT) provides specialized rehabilitation program, which aim at early intervention to assess their home environment and rehabilitation needs. The post-operation rehabilitation is aim at facilitating early safe discharge and engaging them to resume active lifestyle. Patients were divided into SBTKR group and UTKR group. All of them completed the Hong Kong Chinese version of Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire before and after the operation in 6 weeks’ time. The five KOOS subscales of two groups were compared, their demographics data and post-operative ADL status were evaluated.
Result & Outcome :
Total 254 patients (183 female and 72 male) were identified. 81 patients (mean age 65.7 years) had operated SBTKR and 173 patients (mean age 70.6 years) had operated UTKR. 64% of SBTKR group and 66.9% of UTKR group were independent in ADL with walking aids (frame or stick) ≤ 2 weeks. For KOOS, 55 sets and 120 sets were collected for SBTKR group and UTKR group respectively, a significant increase in all KOOS subscales mean scores were noted in both groups on pre- and post-operation comparison (p<0.01, paired t-test). A lower mean scores of all pre- and post-operative KOOS subscales were found in SBTKR group than in UTKR group, but the difference was not significant. Positive comments on expectation of ADL recovery and acceptance of SBTKR were collected. Conclusion: SBTKR and UTKR could attain similar ADL recovery after OT specialized rehab program. It facilitated both patients groups to have significant improvement on their knee functions with benefit of greater cost effectiveness.
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