Bilateral Total Knee Arthroplasties: Comparison of Simultaneous, Sequential, Staged Knee Replacement

ABSTRACT

PURPOSE: To compare the clinical outcomes of bilateral total knee arthroplasty (TKA) performed simultaneously by two teams or sequentially by one team under a single anesthesia, with those of staged bilateral TKA performed during separate hospitalizations. MATERIALS AND METHODS: We retrospectively analyzed 83 patients (166 knees) who underwent bilateral TKA. Group I comprised 25 patients receiving simultaneous bilateral TKA. Group II comprised 31 patients receiving sequential bilateral TKA. Group III comprised 27 patients receiving staged bilateral TKA spaced an average of 8.9 weeks apart. Data including complication rate, length of hospital stay, and allogenic blood transfusion rate were evaluated. RESULTS: Complication rate for group I, II, and III was 12%, 19.4%, and 25.9%, respectively, but there was no significant difference. Allogenic blood transfusion rate was 28%, 29%, and 11.1%, respectively, but there was no significant difference. The average hospital stay was 8.4 days, 8.9 days, and 14.5 days, respectively, and group I and II showed significantly shorter hospitalization compared with group III. CONCLUSION: Simultaneous or sequential bilateral TKA is a safe and efficient procedure that can shorten hospital stay without increasing complication rate and allogenic blood transfusion rate, compared with staged bilateral TKA.