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Background/Objectives: This retrospective study aims to evaluate the safety and functional outcomes of simultaneous bilateral total knee arthroplasty (TKA) compared to two-stage bilateral TKA procedures. Osteoarthritis is the leading cause of knee joint replacement globally, so we sought to determine whether the one-stage approach could be deemed non-inferior to the two-stage method in terms of perioperative complications and postoperative recovery. Methods: We analyzed two cohorts: 43 patients underwent one-stage bilateral TKA, while 66 patients received two-stage TKA. The data collected included demographic details, comorbidities, postoperative complications, and functional outcomes assessed by the Oxford Knee Score (OKS), European Quality of Life, and Visual Analogue Scale scores at preoperative and five years postoperative follow-ups. Results: The results showed statistically significant improvements in quality-of-life measures for both groups, with the one-stage group exhibiting greater enhancement in OKS (p < 0.05). Complication rates were similar across both procedures, with no significant differences in infection rates or other adverse events. Conclusions: This study suggests that the one-stage approach to treat bilateral knee arthritis could reduce subjective stress and healthcare costs, presenting a safe alternative for appropriately selected patients. However, the findings highlight the necessity of considering patients' overall health status when planning surgical interventions. Further research involving larger populations is recommended to validate our conclusions. [ABSTRACT FROM AUTHOR]

The purpose of this narrative review of the recent literature is to analyze the outcomes, complications, and implant survival of total knee arthroplasty (TKA) carried out on people with hemophilia (PWH). It has been shown that TKA substantially alleviates preoperative pain and improves knee function and the patient's quality of life. However, the complication rates of TKA range between 8.5% and 28.7, with postoperative hemarthrosis being the most frequent (7.6%). Besides, when comparing if the TKA was implanted before or after the year 2000, a reduction was found in the rates of periprosthetic joint infection—PJI (6.2% to 3.9%) and aseptic loosening (3.8% to 2.1%). Comparing prosthesis survival between PWH who had suffered early postoperative bleeding complications (EPBC) and patients who did not suffer EBPC, the mean survival duration was 17 years for the EPBC group and 22.1 years for the non-EPBC group. Survival rates were 80% for the EPBC group and 96.4% for the non-EPBC group. Compared to patients without hemophilia, PWH had a substantially higher incidence of PJI (Odds Ratio—OR 1.6) and 1-year revision/re-operation (OR 1.4). In short, although TKA substantially improves the quality of life of PWH, it is an intervention that has a non-negligible percentage of complications. TKA in PWH should preferably be performed only in highly specialized centers for the orthopedic treatment of hemophilia. [ABSTRACT FROM AUTHOR]

The first objective of this paper is to report the clinical and functional results of a cohort of patients who underwent total knee arthroplasty revision at mid–long-term follow-up. The second objective is to investigate possible differences in postoperative functional and clinical outcomes between preoperative-cause-of-revision groups. Methods: we collected data from 105 surgeries performed between January 2008 and December 2014. Eighty-five of these patients were divided into subpopulations according to the causes of revision in order to study differences regarding their outcome. All the patients underwent a standard follow-up protocol with clinical and radiological exams at 1, 3, 6, 12, 24, and 36 months and at last follow-up. During the last follow-up, patient-reported outcome measures (PROMs) were used. We implemented the functional outcomes obtained with clinical data determined by the Oxford knee score (OKS), EQ-VAS, EQ-5D-5L, Knee Society Score (KKS), and range of motion (ROM). Statistically significant differences among the medians of the groups of OKS, EQ-VAS, EQ-5D-5L, KKS, and ROM (p < 0.05) were noticed. The Dunn's test was used to perform post hoc comparisons, and it determined where the differences lie. Results: the median follow-up was 99 months (interquartile range (IQR) 80–115). The median age was 71.5 IQR 65.1–74.8)) with no relevant differences between the groups. More patients presented a preoperative diagnosis of aseptic loosening (29%), malpositioning (28%), and infection (24%), while a preoperative diagnosis of instability (11%) and periprosthetic fracture was observed in fewer cases. For OKS, the highest median value was in the periprosthetic fracture group (43.25, IQR 32.7–45.3) and the lowest median value was in the infection group (24.8, IQR 17.4–34.8). For EQ-VAS, the highest median value was in the periprosthetic fracture group (73.0, IQR 67.0–78.0) and the lowest median value was in the instability group (39.0, IQR 36.0–48.0). For EQ-5D-5L, the highest median value was in the aseptic loosening group (0.81, IQR 0.74-0.85) and the lowest median value was in the infection group (0.44, IQR 0.32–0.60). For KKS, the highest median value was in the aseptic loosening group (84.0, IQR 81.0–88.0) and the lowest median value was in the malpositioning group (56.5, IQR 49.4–66.0). For ROM, the highest median value was in the periprosthetic fracture group (105.0°, IQR 96.0–111.0°) and the lowest median value was in the infection group (88.5°, IQR 77.5–98.0°). Conclusion: Constrained condylar knee (CCK) prostheses can also be considered a good option to manage difficult cases of total knee arthroplasty revision, with satisfactory results being maintained over time; a preoperative diagnosis of infection is associated with a worse clinical and functional outcome. [ABSTRACT FROM AUTHOR]