Is Simultaneous Bilateral Total Knee Arthroplasty (BTKA) as Safe as Staged BTKA?

Simultaneous bilateral total knee arthroplasty (BTKA) is often performed to treat patients with disabling arthritis of both knees. Its use compared with staged procedures remains controversial. In a retrospective study, we compared 371 patients who had simultaneous BTKA with 67 patients who had staged (<6 months apart) BTKA. The staged procedures fall within the crucial postoperative period when increased morbidity and mortality would more likely be present. Primary outcomes were perioperative complications, length of stay, and transfusion requirements. Complications included respiratory arrest, pulmonary embolism, and deep surgical-site infection. Overall, there was no significant difference in complication rates between the 2 cohorts (P = .97). Mean transfusion rate was higher for the simultaneous BTKA group (P = .042). Study limitations included the retrospective design and the relatively small sample, given the low incidence of complications.