Mortality following simultaneous bilateral or staged bilateral total knee arthroplasty: a meta-analysis / 中华骨科杂志

ABSTRACT

Objective To evaluate mortality associated with simultaneous bilateral or staged bilateral TKA, and better understand the risks involved in the simultaneous versus staged bilateral procedures.Methods A systematic review was conducted, following an a priori protocol, according to the methods recommended by the Cochrane Musculoskeletal Group in the Cochrane Collaboration. Eligible studies were identified in PubMed (1990-2010), OVID MEDLINE (1990-2010), and the Cochrane library, concerning postoperative complications of bilateral or staged bilateral total knee arthroplasty. All of the English-language abstracts were obtained, and retrieval words including bilateral total knee arthroplasty, staged total knee arthroplasty, and total knee arthroplasty, etc. An extensive analysis was then performed to identify articles fulfilling the inclusion criteria for the study. The details of the reported data were extracted and evaluated by two reviewers independently. Data analyses were conducted with Stata 10.0. Results Six studies met our inclusion criteria for review. The combined results showed that the prevalence of mortality[OR=2.925, 95% CI (2.352, 3.638)], mortality 30 days postoperatively[OR=5.078, 95% CI (2.192, 1 1.763)]and mortality in 70 years or older patients[OR=4.087, 95% CI (1.947, 8.582)]were statistically higher in the population that had undergone simultaneous TKA compared with staged TKA. Conclusion Compared with staged bilateral TKA, simultaneous bilateral TKA might carries a higher potential risk of postoperative mortality. Patients should be aware of this information when deciding whether to proceed with simultaneous bilateral TKA. Further well-designed and large-scale randomized controlled trials are required to confirm these findings.