RESUMO
Bilateral total knee arthroplasty (BTKA) is a common intervention for bilateral knee osteoarthritis, and the choice between simultaneous (SimBTKA) and staged (StaBTKA) procedures remains a critical decision. This meta-analysis systematically reviews and analyzes the existing literature to compare mortality outcomes associated with SimBTKA and StaBTKA. A comprehensive search was conducted across major databases for studies reporting mortality outcomes in SimBTKA and StaBTKA. Inclusion criteria encompassed studies published up to the cutoff date of January 2023, and a total of 37 studies were included in the quantitative synthesis. Meta-analysis was performed using a random-effects model to calculate odds ratios (ORs) with 95% confidence intervals (CIs) using the Review Manage 5.4 software. The meta-analysis included 86,333 SimBTKA cases and 115,146 StaBTKA cases. The overall mortality rate in SimBTKA was 0.66%, while StaBTKA's was 0.43%. The pooled OR for mortality in SimBTKA versus StaBTKA was 1.55 [1.16, 2.08], indicating a statistically significant higher mortality risk in SimBTKA. Our findings suggest that SimBTKA is associated with an increased risk of mortality compared to StaBTKA. This meta-analysis provides valuable insights into the comparative mortality outcomes of SimBTKA and StaBTKA. While SimBTKA may offer potential advantages, including a single anesthesia event and shorter recovery time, clinicians should consider the increased mortality risk associated with this approach. Future research should focus on prospective studies with standardized reporting to further elucidate the nuanced factors influencing mortality outcomes in bilateral knee arthroplasty.
RESUMO
Objective This cross-sectional study aimed to identify and analyze misconceptions prevalent in Saudi Arabian society regarding intra-articular injections and their sources. It also sought to explore factors influencing patients' decision-making in the context of osteoarthritis (OA) treatment. Methods A sample of 405 adult participants from various educational backgrounds residing in Saudi Arabia completed a self-administered questionnaire. The survey focused on participants' knowledge about intra-articular injections, their sources of information, and their beliefs and perceptions related to these injections. Results The study unveiled a significant lack of awareness among the participants, with almost half (48.4%) reporting no knowledge of intra-articular injections. Of all, 16.1% held misconceptions about these injections, including believing that they are painful or they liquify the bone. Participants expressed varied thoughts on the effects of intra-articular injections, with 69.6% associating them with short-term pain relief. While 60.2% disagreed that intra-articular injections could provide long-term pain relief, 65.2% believed that these injections could delay the need for surgery. The source of knowledge varied, with 34.4% relying on orthopedics and 32.5% on friends and relatives. In those who had received intra-articular injections (n = 62), 83.9% cited the desire to delay or avoid surgery as a reason. While 56.5% were very satisfied with their doctor's guidance, 46.8% expressed concerns about relying on injections in the future. Furthermore, educational levels were correlated with knowledge, highlighting the need for more accessible and tailored patient education materials. However, even among those with a university education, misconceptions persisted. Effective patient-doctor communication was associated with secondary or university education (χ² = 11.05, p = 0.011). Conclusion The prevalence of misconceptions regarding intra-articular injections in Saudi Arabia underscores the need for comprehensive patient education and improved communication between healthcare providers and patients. Addressing these misconceptions is essential for empowering patients to make informed decisions about their healthcare and enhancing the overall quality of care they receive. This study's findings have implications not only for Saudi Arabia but also for healthcare systems globally, emphasizing the significance of patient-centered care and informed decision-making.
