Infection following simultaneous bilateral total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Infectious Disease Epidemiology
• Arthroplasty Research

Background:

• Total knee arthroplasty (TKA) is a common procedure for end-stage knee arthritis.
• Different surgical approaches, including simultaneous bilateral total knee arthroplasty (SBTKA), staged bilateral total knee arthroplasty, and unilateral total knee arthroplasty (UTKA), exist.
• Understanding infection rates associated with each approach is crucial for patient outcomes.

Purpose of the Study:

• To compare infection rates and characteristics among patients undergoing SBTKA, staged TKA, and UTKA.
• To evaluate the safety and efficacy of SBTKA concerning infectious complications.
• To identify risk factors for infection following different TKA approaches.

Main Methods:

• Retrospective comparison of 17,837 patients undergoing TKA between 2000 and 2009.
• Categorization into SBTKA (16%), staged (6%), and UTKA (78%) groups.
• Analysis of demographics, clinical characteristics, and infection details, including in-hospital, late, and superficial infections.

Main Results:

• SBTKA demonstrated a significantly lower overall infection rate (0.57%) compared to staged (1.39%) and UTKA (1.1%).
• In-hospital and superficial infection rates were significantly lower in the SBTKA group.
• Regression analysis indicated UTKA patients were 2.5 times, and staged patients 3.4 times more likely to develop in-hospital infections compared to SBTKA.

Conclusions:

• SBTKA offers an advantage over staged and unilateral approaches regarding infectious complications.
• SBTKA maintains a comparable safety profile to unilateral TKA concerning infection risk.
• Surgical approach in TKA significantly impacts in-hospital infection rates, with SBTKA showing a protective effect.