Simultaneous bilateral total knee arthroplasty for rheumatoid arthritis.
OBJECTIVE: To study the result of one staged bilateral total knee arthroplasty (TKA) operation under epidural anesthesia on patients with severe rheumatoid arthritis (RA). METHODS: From April 1987 to December 1992, simultaneous bilateral TKA was performed on 45 patients (90 knees), including 41 patients with RA, 3 with juvenile RA, and 1 with Sjogren syndrome. The mean follow-up period was 63 months. RESULTS: Improved function and pain relief were noted in all patients. There were no wound healing problems. Thrombophlebitis was observed in few cases. Late infection rate was 5.6% (5 knees) and aseptic loosening was revised on 5 knees. CONCLUSIONS: Simultaneous bilateral TKA is not only a procedure of low cost, saving blood, reducing anesthesia risk, drugs' side effect and hospitalization, but also facilitates early rehabilitation. Except for late infection, there is no increase in complications.