Comparing Unilateral and Bilateral Total Knee Replacement Based on the Functional Approach

Total Knee Replacement (TKR) is the treatment of choice for severe osteoarthritis with acceptable outcomes regarding pain management, function and quality of life enhancement. Because many patients require TKR procedure for their both knees, there has always been a challenge in the choice of simultaneous or consecutive operations. The aim of the present study was to compare the two protocols based on functional capabilities of patients with osteoarthritis (OA). In this quasi-experimental study, twenty five severe patients with OA candidates for bilateral TKR (sampled by simple convenient method) were assigned into unilateral (3 men, 9 women) and bilateral (3 men, 10 women) groups based on the preference of the patients for the surgery procedure. Knee Injury and Osteoarthritis Outcome Score (KOOS) was used to evaluate functional capabilities of the patients prior to and 6 weeks after the operation and rehabilitation program. Repeated measures analysis of variance was used for the statistical analysis by SPSS 21 software. The findings indicated that the KOOS scores of the 2 groups were not significantly different before or after the interventions. Besides, patients in both groups showed significant improvement after TKR and the following rehabilitation program (P<0.01 for both groups and all KOOS subscales). TKR and the post-operative rehabilitation program could significantly enhance function of the severe OA patients but no priority for either unilateral or simultaneous bilateral methods was recognized.