Early morbidity and mortality after single-stage bilateral total knee replacement

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Patient Safety

Background:

• Single-stage bilateral total knee replacement (TKR) offers advantages like reduced hospital stays, anesthesia sessions, and costs.
• However, the perioperative risks associated with this approach remain a concern.

Purpose of the Study:

• To evaluate the safety and efficacy of single-stage bilateral TKR in patients selected based on their American Society of Anesthesiologists (ASA) score.
• To determine if this strategy leads to increased early perioperative mortality, morbidity, or readmission rates.

Main Methods:

• A retrospective cohort study of 116 patients (ASA-1 and ASA-2) who underwent single-stage bilateral TKR between 2009 and 2016.
• Analysis of early mortality, complications (major and minor), and readmission rates within 90 days post-operation.
• Evaluation of blood transfusion rates and the impact of tranexamic acid administration.

Main Results:

• Zero early perioperative mortality was observed in the selected patient cohort.
• The rate of major complications was 4.3%, and minor complications were 11%.
• The early readmission rate was 5.2%, with tranexamic acid showing a trend towards reduced homologous blood transfusion rates.

Conclusions:

• Single-stage bilateral TKR is a valid and safe strategy for carefully selected patients (ASA-1 and ASA-2).
• The study demonstrates acceptable early morbidity and low readmission rates in this population.
• This approach can be considered for patients meeting specific criteria, balancing benefits against perioperative risks.