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Bilateral Simultaneous vs Staged Total Knee Arthroplasty: A Comparison of Complications and Mortality
Dhiren S Sheth1, Guy Cafri2, Elizabeth W Paxton2
1Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Irvine, California.
Background:
The purpose of this study was to compare the complications and mortality between bilateral simultaneous total knee arthroplasty (BTKA-Simultaneous) and bilateral staged TKA (BTK-Staged) while adjusting for differences in patient, surgeon, and hospital characteristics.
Methods:
An integrated health care system total joint registry was used to compare patients undergoing BTKA-Simultaneous to BTKA-Staged. For outcomes related to revision and infection, the sample included 11,118 patients, and for outcomes of death, acute myocardial infarction, stroke, and venous thromboembolism, a subsample of 7991 patients with comorbidity data was selected.
Results:
Overall death and complications in both groups were rare. The complication rates for BTKA-Simultaneous and BTKA-Staged were comparable: aseptic revision (1.17% vs 0.9%), septic revision/deep infection (0.8% vs 0.7%), death (0.28% vs 0.1%), and adverse events (2.49% vs 1.97%). In the adjusted models, there were no significant differences in any of the outcomes between the 2 groups.
Conclusion:
There is a lack of evidence to support superiority of either BTKA-Simultaneous or BTKA-Staged.
