Comparison the physical performance, static-dynamic balance of patients who have undergone unilateral and bilateral total knee arthroplasty

Aim: The study is planned to compare the physical performance, static-dynamic balance of patients who have undergone unilateral and bilateral total knee arthroplasty at 6th and 12th months after their operations. Patients and Methods: The study was included 80 patients, of them, 35 (mean age 67.11±9.37 years) had unilateral total knee arthroplasty and 45 (mean age 67.17±7.32 years) bilateral total knee arthroplasty. After their preoperative and postoperative knee scores according to ?The Hospital for Special Surgery? scale, knee flexion ranges and muscle strength were measured to make assure matched with the groups, all the patients in the both groups were assessed for physical performance and static-dynamic balance using balance master test device on their 6th and 12th months postoperatively. Results: Comparing with the bilateral knee arthroplasty, unilateral total knee arthroplasty patients, showed a statistically significant difference in weight bearing on each extremities in favour of nonoperated limb (p<0.05). There were no significant differences in clinical test of sensory interaction on balance and unilateral stance of static balance assessment between the patients in bilateral and unilateral group (p>0.05), it was determined that the patients with bilateral total knee arthroplasty patients had better performance on limits of stability of dynamic balance evaluations (p<0.05), and there was no significant difference between rhythmic weight shift tests (p>0.05). Of the physical performance tests, there was no significant difference in sit-to-stand test at the 6th month (p>0.05), whereas patients with bilateral total knee arthroplasty could perform the test a shorter duration at 12th month (p<0.05). The difference in lift-up index of step-up and over test between operated and non-operated knees was higher in the patients with unilateral total knee arthroplasty (p<0.05). Discussion and Conclusion: While dynamic balance parameters in the daily activities of patients with bilateral total knee arthroplasty are expected to be better than patients with unilateral total knee arthroplasty, there was no significant difference between static balance and physical performance parameters of the two groups. Therefore, it was found that the bilateral TKA is more preferable surgery method than unilateral TKA. In addition to previous studies which reported less hospitalization period and lower costs for the bilateral TKA patients, we have concluded that these patients had more advantages for dynamic balance which is important to perform activities of daily living. The present study demonstrates a necessity to include the dynamic balance assessments and training to current physical therapy programmers.