Simultaneous bilateral sequential total knee replacement is as safe as unilateral total knee replacement.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Total knee replacement (TKR) is a common procedure for end-stage knee osteoarthritis.
• Bilateral TKR can be performed simultaneously or sequentially, raising questions about comparative safety.
• Assessing risks in both low- and high-risk patient populations is crucial for surgical decision-making.

Purpose of the Study:

• To compare mortality and complication rates between simultaneous bilateral sequential TKR and unilateral TKR.
• To evaluate these outcomes in distinct low-risk and high-risk patient cohorts.
• To determine the safety profile of bilateral sequential TKR.

Main Methods:

• Retrospective study comparing 2385 patients undergoing bilateral sequential TKR with 719 patients undergoing unilateral TKR.
• Analysis of peri-operative mortality and rates of major and minor complications.
• Stratification of patients into low-risk and high-risk groups based on pre-operative factors.

Main Results:

• Peri-operative mortality rates were similar between bilateral sequential TKR (0.3%) and unilateral TKR (0.7%).
• No significant differences in major or minor complication rates were observed between bilateral and unilateral TKR groups.
• Mortality and complication rates were comparable across low- and high-risk patients within both bilateral and unilateral TKR groups.

Conclusions:

• Simultaneous bilateral sequential TKR is a safe procedure with outcomes comparable to unilateral TKR.
• The procedure can be confidently offered to both low-risk and high-risk patients.
• Evidence supports bilateral sequential TKR as a viable option with similar risk profiles to unilateral procedures.