목적: 저위험군 환자에게 있어 한 번의 마취하에 시행한 양측 슬관절 전치환술의 안전성을 알아보고자 한다. 대상 및 방법: 양측에 인공슬관절 전치환술을 시행받은 310명(620예)을 대상으로 저위험군 환자이면서 한번의 마취하에 시행한 경우를 제 1군(179명), 2주 간격으로 시행한 경우를 제 2군(97명), 한쪽을 수술 후 재입원하여 반대측을 시행한 경우를 제 3군(34명)으로 구분하여 수술 후 합병증, 수술 후 총 출혈량, 평균 수혈량, 수술시간, 입원기간을 비교분석 하였다. 결과: 1,2,3군 모두에서 주요 합병증 발생은 없었고, 강한 합병증이 각각 5%, 7.2%, 5.8% 발생하였으나 통계적으로 유의한 차이는 없었다. 수술 후 총 평균 출혈양은 각각 1,442.9 ㎖, 1,567.4 ㎖, 1,616.6 ㎖로 각 군간에 유의한 차이는 없었으나(p>0.05), 평균 수혈량은 각각 1,220.3 ㎖, 680.1 ㎖, 692.2 ㎖로 1군에서 수혈의 양이 가장 많았다(p<0.05). 평균 수술시간은 각각 186분, 196분, 211분으로 1군에서 적게 소요되었으며(p<0.05), 총 평균 입원 기간은 각각 16.8일, 28.6일, 29.8일로 1군이 짧았다(p<0.05). 결론: 특별한 내과적 문제가 없는 저위험 환자에서는 한번의 마취하에 양측을 동시에 인공슬관절 전치환술을 시행할 수 있다고 생각된다.
Purpose: To study the safety of sequential bilateral total knee arthroplasty in low risk patients. Materials and Methods: Those who had received the surgery all at once were grouped as the first group, those who had received the surgery over two weeks interval were the second group and the last group, third group were those who had received the first surgery on only one knee and they were gotten re-hospitalized for the second surgery on the rest of the knee. These groups were compared on the aspects of complication, postoperative bleeding amount, average transfusion amount, operation time and admission period. Results: There were no major complications found in all groups and the minor complication rate of occurrence was 3%, 4%, 6% in each, which did not constitute a significance difference. Each of the total blood loss was 1442.9 ㎖, 1567.4 ㎖, 1616.6 ㎖ and which did not constitute a significance difference, either. Each of the average volume of blood transfused was 1220.3 ㎖. 680.1 ㎖, 692.2 ㎖, and the first group had the largest volume transfused (p<0.05). The operation time was 186, 196, 211 minutes in each and the first group had the shortest duration (p<005) The average admission periods were 16.8, 28.6, 29.8 days and the first group had the shortest period (p<005). Conclusion: We suggest that when there are no medical diseases contracted on patients, the sequential bilateral total knee arthroplasty can be performed safely without definite increase in perioperative complications.