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Updated: Dec 20, 2025

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve

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Simultaneous single-stage versus two-staged bilateral total knee arthroplasty: a prospective comparative study.

Tarun Goyal¹, Md Quamar Azam², Anjum Syed³

¹Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India. goyal.tarun@gmail.com.

International Orthopaedics

|May 28, 2020

Summary

Simultaneous single-stage bilateral total knee arthroplasty (SS BLTKA) shows comparable safety and outcomes to staged procedures. While SS BLTKA requires more transfusions, it reduces hospital stay and surgery duration for severe osteoarthritis.

Keywords:

Cardiopulmonary complications Knee replacement Single-stage Staged Total knee arthroplasty

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Published on: July 5, 2011

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Area of Science:

Orthopedic Surgery
Arthroplasty Research
Peri-operative Care

Background:

Bilateral total knee arthroplasty (TKA) can be performed either simultaneously in a single stage (SS BLTKA) or in two stages (TS BLTKA).
Choosing between SS BLTKA and TS BLTKA involves balancing surgical efficiency with potential peri-operative risks.

Purpose of the Study:

To prospectively compare the peri-operative morbidity and mortality between SS BLTKA and TS BLTKA.
To evaluate functional outcomes, including Oxford knee score and SF12 quality of life index, at 6-week and 6-month follow-ups.

Main Methods:

A prospective study comparing 250 patients undergoing SS BLTKA with 210 patients undergoing TS BLTKA (within 12 months).
Minimum follow-up of 12 months; assessment of peri-operative complications, mortality, functional scores (Oxford knee score, SF12), and range of motion.

Main Results:

No significant differences in peri-operative mortality, surgical site infection, or major complications between SS BLTKA and TS BLTKA.
Similar Oxford knee scores, SF12 scores, and knee flexion at 6-month follow-up.
SS BLTKA showed a higher post-operative hemoglobin drop and blood transfusion rate, but TS BLTKA had longer hospital stays and surgery durations.

Conclusions:

SS BLTKA and TS BLTKA demonstrate comparable complication rates and functional outcomes.
SS BLTKA is a viable option for patients with severe bilateral knee osteoarthritis, excluding those with severe cardiopulmonary compromise.
Unilateral procedures may be preferable for patients with significant cardiopulmonary issues.