One-week staged bilateral total knee arthroplasty protocol: a safety comparison of intended and completed surgeries

The number of patients requiring bilateral total knee arthroplasty (TKA) is expected to grow rapidly. While some trials have compared staged with simultaneous TKA, no literature characterizes the subset of staged TKA patients who cancel their second surgery. In this study, we report on the safety and utility of a one-week staged TKA protocol in a series of 145 patients who registered to undergo staged bilateral total knee arthroplasty one week apart. Among these patients, we identify a significantly higher complication rate and comorbidity status among patients who do not proceed to a second TKA. This finding identifies a potential advantage of a staged protocol over simultaneous bilateral TKA in not subjecting higher-risk patients to a second physiologic insult of a contralateral TKA.