Perioperative Safety of Patients Undergoing Unilateral or Simultaneous Bilateral Total Knee Arthroplasty

Objective To analyze the perioperative safety of patients undergoing unilateral or simultaneous bilateral total knee arthroplasty(TKA). Methods Totally 500 patients who had undergone unilateral or simultaneous bilateral TKA between December 2014 to December 2015 were retrospectively reviewed. They were divided into two groups:unilateral group(n=310)and bilateral group(n=190).The general data,perioperative transfusion,and complications were compared between these two groups. Results Patients in unilateral group had significantly higher ASA scores(χ²=8.344,P=0.015) and NYHA grade(χ²=7.537,P=0.023)than in bilateral group.Patients in bilateral group had significantly higher posterior drainage volume(t=44.984,P=0.000). Transfusion rate(χ²=42.896,P=0.000) was significantly higher and the lowest postoperative hemoglobin was significantly lower(t=0.006,P=0.000)in the bilateral group. The episodes of transfusion(χ²=1.025,P=0.599) and the amount of transfused packed red blood cells(χ²=3.836,P=0.429) were similar between two groups. There was no significant difference in the length of postoperative hospital stay(t=0.310,P=0.756),admission to intensive care unit(χ²=0.317,P=0.895),and incidences of complications(χ²=0.047,P=0.475). Conclusions For patients with low ASA scores and NYHA grade,simultaneous bilateral TKA is recommended. For older patients with high ASA score,poor cardiac function,and high incidences of complications,unilateral TKA is recommended.