BACKGROUND:The safety and efficacy of simultaneous bilateral total knee replacement or selective unilateral total knee arthroplasty in patients with severe osteoarthritis of the knees are stil controversial. OBJECTIVE:To compare safety and clinical efficacy of patients with osteoarthritis knees after simultaneous bilateral total knee replacement or selective unilateral total knee replacement. METHODS:Total y 60 cases with severe osteoarthritis of the knees (90 knees) undergoing total knee replacement were divided into unilateral total knee replacement group (n=30, 30 knees), and the simultaneous bilateral total knee replacement group (n=30, 60 knees). RESULTS AND CONCLUSION:There was no significant difference in the incidence of other complications such as infection, mortality, pulmonary embolism in patients of both groups (P>0.05). The incidence of cardiovascular complications, postoperative blood loss and blood transfusion were higher in the bilateral knee group than in the unilateral knee group (P<0.05). During fol ow-up at 1 year after replacement, no significant differences in range of motion, muscle strength of quadriceps and hospital for special surgery knee score were detected in patients of both groups (P>0.05). However, Visual Analogue Scale scores were significantly lower in the bilateral knee group than in the unilateral group (P<0.05). These data indicated that the risk of cardiovascular complications was high in patients receiving bilateral total knee replacement. Patients with severe cardiovascular disease should avoid simultaneous bilateral total knee arthroplasty.

Glioblastoma (GBM) is one of the most threatening diseases of the central nervous system, and the prognosis has not improved despite the constant updating of therapeutic approaches. However, the introduction of tumor treating fields (TTFields) has changed the treatment of newly diagnosed and recurrent GBM. TTFields is a novel non-invasive therapy for the treatment of tumors using mid-frequency and low-intensity alternating electric fields, which is important for the treatment of central nervous system diseases such as GBM. TTFields has fewer side effects and greater local efficacy than traditional treatment modalities. In addition, the combination of chemotherapeutic drugs and radiotherapy with TTFields has shown significant advantages and may become one of the future clinical treatment strategies. Despite the potential of TTFields in the treatment of GBM, a number of limitations remain, including issues of device dependency, discomfort during use and tolerability in some patients. Therefore, the use of TTFields needs to be further optimized to maximize their therapeutic potential in patients with GBM and to provide more effective treatment options for patients.