Bilateral total knee arthroplasty--staged or simultaneous? Ontario's orthopedic surgeons reply.

摘要: Background: Total knee replacement is now the most common joint procedure performed in Ontario, and many patients require bilateral replacement. However, whether total arthroplasty (TKA) should be staged or simultaneous hotly debated. To determine current operative practices of orthopedic surgeons we carried out a province-wide survey. Methods: Orthopedic from Ontario listed 1999 Canadian Medical Directory membership list Orthopaedic Association were sent questionnaires, asking about their practice timing TKA, tourniquet use, type guide use techniques to minimize fat embolization. Results: Of 416 surveys mailed, 219 (53%) responded. The majority responded that they perform TKA (28% 3-mo interval 37% 6-mo interval). Simultaneous with 2 teams was least (2%). When performing 95% an intramedullary femoral alignment guide, 78% utilize over-reamed entry hole 53% suction canal before inserting rod. With respect tibia, 32% 60% over-ream hole; 22% stated had never considered over-reaming suctioning Conclusions: There no consensus regarding Ontario. Furthermore, are not overdrilling despite evidence literature may beneficial decreasing Further research required compare risk complications after versus TKA. Contexte : L’arthroplastie totale du genou est maintenant l’arthroplastie la plus courante pratiquee en et beaucoup de ont besoin d’une intervention bilaterale. La question savoir si (ATG) bilaterale peut etre realisee deux temps ou simultanement souleve toutefois des debats animes. Afin determiner les pratiques operatoires communes courantes chirurgiens orthopedistes l’Ontario, nous avons procede un sondage provincial. Methodes On envoye aux l’Ontario figurant dans l’edition Repertoire medecins canadiens sur liste membres l’Association canadienne d’orthopedie questionnaires portant pratique relative l’execution d’ATG bilaterales, l’utilisation tourniquet, le tige guidage visant reduire possible formation d’embolies graisseuses. Resultats Sur envoyes chirurgiens, on obtenu reponses (53 %). majorite repondu qu’ils procedent ATG bilaterales decalees (28 % intervalles trois mois 37 six mois). L’ATG simultanee par equipes constituait l’intervention moins frequente (2 Lorsqu’ils pratiquent une bilaterale, 95 utilisent d’alignement intramedullaire, 78 orifice d’entree surdimensionne 53 succionnent avant d’y introduire guidage. En ce qui concerne 32 60 surdimensionnent l’orifice succionnent, 22 declare n’avaient jamais envisage surdimensionner succionner afin au minimum Conclusions Il n’y