Bilateral Simultaneous Versus Staged Total Knee Replacement: A Comparison of Complications and Mortality

• Published in: The Journal of arthroplasty 2016
• Main Authors: Sheth, Dhiren S., MD, Cafri, Guy, PhD, Paxton, Elizabeth W., MA, Namba, Robert, MD
• Format: Article
• Language: English
• Subjects: Orthopedics
• ISSN: 0883-5403
• DOI: 10.1016/j.arth.2016.03.018

Background The purpose of this study is to compare the complications and mortality between bilateral simultaneous total knee replacement (BTKR-Simultaneous) and bilateral staged TKR (BTK-Staged) while adjusting for differences in patient, surgeon and hospital characteristics. Methods An integrated healthcare system total joint registry was used to compare patients undergoing BTKR-Simultaneous to BTKR-Staged. For outcomes related to revision and infection the sample included 11,118 patients and for outcomes of death, acute myocardial infarction, stroke, and venous thromboembolism a subsample of 7,991 patients with comorbidity data was selected. Results Overall death and complications in both groups were rare. The complication rates for BTKR-Simultaneous and BTKR-Staged were comparable: Aseptic revision (1.17% vs 0.9%), septic revision/deep infection (0.8% vs 0.7%), death (0.28% vs 0.1%) and adverse events (2.49% vs 1.97%). In the adjusted models there were no significant differences in any of the outcomes between the two groups. Conclusion There is a lack of evidence to support superiority of either BTKR-Simultaneous or BTKR-Staged.