目的:由于其经济优势,同时使用了双侧全膝关节置换术(TKA),总体资源使用情况,和方便患者。受训者执行第一个TKA的训练模型,接下来是教练外科医生进行第二次TKA,是我们机构的独特模式。本研究旨在分析由受训者或监督外科医生进行双侧同步TKA的功能和临床结果,并根据受训者或外科医生的哪一方来评估这些结果。
方法:这是一项回顾性队列研究,研究了2003年5月至2017年11月期间由一名外科医生在学术机构进行的所有同时进行的双侧TKAs。排除标准是使用部分膝关节置换术,分阶段的双边程序,以及一方的高级作者和另一方的受训者未执行的程序。感兴趣的主要临床结果包括修订和重新修订。主要功能结果包括牛津膝关节评分(OKS)和患者满意度评分。
结果:总计,包括315名患者(630个膝盖)进行分析。其中,189例患者(378膝)可获得功能评分.所有膝盖的全因翻修率为1.9%(n=12)。总的来说,十名患者中的12个膝盖被修改,两名患者的右膝和左膝均进行了修正。受训者和监督外科医生的OKS和患者满意度得分具有可比性。大多数患者(88%,n=166)可能性很大(67%,n=127)或可能(21%,n=39)向朋友推荐双边TKA。
结论:同步双侧TKA可作为受训者的有效教学模式,对患者的临床或功能结局没有任何重大影响。双膝均具有出色的功能和临床效果,无论执行外科医生是实习生还是监督外科医生,可以同时进行双侧TKA。引用这篇文章:BoneJtOpen2022;3(1):29-34。
OBJECTIVE: Simultaneous bilateral total knee arthroplasty (TKA) has been used due to its financial advantages, overall resource usage, and convenience for the patient. The training model where a trainee performs the first TKA, followed by the trainer surgeon performing the second TKA, is a unique model to our institution. This study aims to analyze the functional and clinical outcomes of bilateral simultaneous TKA when performed by a trainee or a supervising surgeon, and also to assess these outcomes based on which side was done by the trainee or by the surgeon.
METHODS: This was a retrospective cohort study of all simultaneous bilateral TKAs performed by a single surgeon in an academic institution between May 2003 and November 2017. Exclusion criteria were the use of partial knee arthroplasty procedures, staged bilateral procedures, and procedures not performed by the senior author on one side and the trainee on another. Primary clinical outcomes of interest included revision and re-revision. Primary functional outcomes included the Oxford Knee Score (OKS) and patient satisfaction scores.
RESULTS: In total, 315 patients (630 knees) were included for analysis. Of these, functional scores were available for 189 patients (378 knees). There was a 1.9% (n = 12) all-cause revision rate for all knees. Overall, 12 knees in ten patients were revised, and both right and left knees were revised in two patients. The OKS and patient satisfaction scores were comparable for trainees and supervising surgeons. A majority of patients (88%, n = 166) were either highly likely (67%, n = 127) or likely (21%, n = 39) to recommend bilateral TKAs to a friend.
CONCLUSIONS: Simultaneous bilateral TKA can be used as an effective teaching model for trainees without any significant impact on patient clinical or functional outcomes. Excellent functional and clinical outcomes in both knees, regardless of whether the performing surgeon is a trainee or supervising surgeon, can be achieved with simultaneous bilateral TKA. Cite this article: Bone Jt Open 2022;3(1):29-34.