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目的：比较同一住院周期1次手术、同一住院周期分次手术与分次住院行双侧膝关节表面置换术( total knee arthroplasty，TKA )的疗效及其影响因素。方法回顾性分析2003年至2011年，在我科接受双膝关节表面置换的病例共378例，其中352例获得为期2年的随访。根据双侧膝关节手术间隔时间不同，分为同一住院周期1次手术组128例( A 组)、同一住院周期分次手术组118例( B 组)与分次住院组106例(C组)，比较3组患者术前因素、术后并发症、疗效差异。结果患者年龄A组(65.0±6.8)岁低于B组(70.8±7.6)岁和C组(70.2±7.7)岁，差异有统计学意义( P＜0.05)，B组与C组差异无统计学意义( P＞0.05)；术前合并症A组少于B，C两组，差异有统计学意义( P＜0.05)；总住院时间，A组(13.6±3.2)天，较B组(22.5±6.2)天与C组(27.4±7.3)天短，差异有统计学意义( P＜0.05)，后两组差异无统计学意义( P＞0.05)；围术期输血量，A组(732.4±375.1) ml，高于B组(501.7±207.2) ml和C组(510.9±208.8) ml，差异有统计学意义( P＜0.05)，而 B、C 两组间，差异无统计学意义( P＞0.05)；A，B，C 3组手术前后的 HSS 评分差值分别为(32.9±12.3)，(33.2±12.8)，(33.4±11.9)；围术期总出血量分别为(1071.6±112.3) ml，(986.4±121.7) ml，(1036.1±98.7) ml；总手术时间分别为(171.9±30.1) min，(183.7±32.2) min，(182.7±32.4) min；术后并发症的发生率及病死率A，B，C 3组差异均无统计学意义( P＞0.05)。结论在患者基础条件允许和充分的术前准备条件下，同期双膝置换可获得与分期双膝置换或分次住院行双膝关节置换同样的远期疗效。“,”Objective To analyze the influence factors and compare the curative effects of simultaneous bilateral total knee arthroplasty ( TKA ) in 1 hospitalization period, staggered bilateral TKA in 1 hospitalization period or staggered bilateral TKA in 2 hospitalization periods.Methods From 2003 to 2011, 378 patients undergoing simultaneous and staged bilateral TKA were enrolled in the study, among whom 352 patients were followed up for at least 2 years. All the patients were divided into 3 groups based on the surgical intervals, including group A of simultaneous bilateral TKA in 1 hospitalization period (n=128 ), group B of staggered bilateral TKA in 1 hospitalization period (n=118 ) and group C of staggered bilateral TKA in 2 hospitalization periods (n=106 ). A retrospective review of each group was conducted to compare the preoperative factors, postoperative complications and differences of curative effects.Results The average age in group A was ( 65.0±6.8 ) years old, who were older than ( 70.8±7.6 ) years old in group B and ( 70.2±7.7 ) years old in group C, and the differences were statistically signiifcant (P0.05 ). The preoperative complications of group A were less than that in group B and group C, and the differences were statistically signiifcant (P0.05 ). Conclusions With well preoperative preparation and reasonable patient selection, the same long-term curative results can be achieved in simultaneous bilateral TKA in 1 hospitalization period as in staggered bilateral TKA in 1 hospitalization period or in staggered bilateral TKA in 2 hospitalization periods.