Reemplazo total de rodilla bilateral: Análisis de costos entre uno y dos tiempos

background: one third of all patients undergoing unilateral hip or knee replacement suffer bilateral symptomatic disease. the main purpose of this study was to evaluate and compare the cost of bilateral total knee replacement, in one or two stages, to the patient and / or the health care system. methods: we included patients operated on for simultaneous bilateral total knee replacement between 2004 and 2008. also included were 12 patients operated on for bilateral total knee replacement in 2 stages randomly performed. parameters such as: age, sex, diagnosis, type of surgery, type of anesthesia, length of surgery, type of prosthesis, hospital days, rehabilitation days, transfusions and medications were taken into account. in each case the following were also recorded: return to the or, icu stay, discharge to rehabilitation center, readmission within the first 7 days of discharge, and death within thirty days from surgery. we obtained the exact final cost of each procedure. group a: 13 patients (26 knees). age: 68.8 years (range 56-78). diagnosis: arthritic genu varum (25 knees) and arthritic genu valgus (1 knee). group b: 12 patients (24 knees). age: 68.2 years (range 23-94). diagnosis: arthritic genu varum (19 knees), rheumatoid arthritis (4 knees) and arthritic genu valgus (1 knee). results: implants' cost was the same in both groups: ar pesos 18,000, i.e., ar pesos 9,000 each implant. the cost of transfusions amounted to ar$ 3,560 (ar $ 1,235- 5,815) in the first group and ar $ 3,860 (ar $ 1,055- 6,880) in the second. the cost of or use was ar$ 2,875 (ar$ 1,680-3,360) for the first group versus ar$ 3,202 (ar$ 2,310-3,780). in group a the average hospitalization cost was ar$ 5,539 (ar$ 4,696-10,958), whereas for group b, the cost was ar$ 9,783 (ar$ 7,040- 20,351). analyzing the difference, note that the value is nearly twice that of the first group. hospital rehabilitation cost was ar$ 495 (ar$ 420-980) in group a, and ar$ 873 (ar$ 560-1,820) in group b. conclusion