Simultaneous vs staged bilateral total knee arthroplasty: a propensity-matched case-control study from nine...

Area of Science:

• Orthopedic Surgery
• Patient Safety
• Arthroplasty Outcomes

Background:

• Limited data exists comparing patient safety between simultaneous and staged bilateral total knee arthroplasty (TKA).
• Understanding outcomes is crucial for optimizing surgical approaches and patient care.

Purpose of the Study:

• To compare length of stay, in-hospital complications, 30-day readmissions, and mortality between simultaneous and staged bilateral TKA in matched patients.
• To provide evidence-based insights into the safety profiles of these bilateral TKA procedures.

Main Methods:

• A retrospective case-control study utilizing prospectively collected data from nine centers (2010-2015).
• Propensity score matching was employed to compare simultaneous and staged bilateral TKA patients.
• 30-day follow-up data were obtained from the Danish Patient Registry and patient records.

Main Results:

• Matched analysis included 232 simultaneous and 232 staged bilateral TKA patients.
• Simultaneous TKA had a higher in-hospital complication rate (15.5% vs 7.3%, p=0.004) and re-operation rate (3.4% vs 0.4%, p=0.037).
• No significant differences were observed in length of stay, 30-day readmission rates, or mortality.

Conclusions:

• While 30-day readmissions and mortality were comparable, simultaneous bilateral TKA is associated with increased in-hospital complications and re-operations.
• Further matched investigations in larger cohorts are warranted to fully elucidate the safety differences.
• These findings suggest careful consideration of the risks associated with simultaneous bilateral TKA.