Bilateral Total Knee Arthroplasty: Predictors of Discharge Disposition

Total knee arthroplasty is on the rise. Some patients choose to undergo simultaneous bilateral total knee arthroplasty (simultaneous BTKA). No studies were found that examined which patients may be better candidates to successfully undergo this procedure.

The purpose of this study was to determine personal and comorbid characteristics of patients undergoing simultaneous BTKA that are predictive of length of stay (LOS) and discharge to a skilled nursing facility (SNF).

A retrospective database study of 125 patients post-simultaneous BTKA was conducted. Binary and multiple linear regression models identified personal and clinical predictors of LOS and SNF discharge.

Body mass index (BMI) (p < .001) and SNF discharge (p = .025) were significant predictors of increased LOS and explained 18% of the variance. Older age, female sex, and presence of cardiopulmonary disease predicted SNF admission; 21% of the variance for SNF discharge was explained by the model.

Patients with a high BMI should be carefully screened before undergoing simultaneous BTKA; older patients, women, and those with cardiopulmonary disease may benefit from early discharge planning for SNF transfer, thereby decreasing LOS and hospital utilization.