Complications Associated With Same-Day Bilateral Total Knee Arthroplasties

Area of Science:

• Orthopedic Surgery
• Arthroplasty Research
• Patient Safety and Outcomes

Background:

• Same-day bilateral total knee arthroplasties (SBTKAs) offer potential benefits like reduced rehabilitation time and lower costs.
• However, concerns regarding the safety of SBTKAs persist, with a need to evaluate if current patient selection aligns with unilateral total knee arthroplasty (UTKA) safety profiles.

Purpose of the Study:

• To compare patient and hospital characteristics, inpatient course, and complications between same-day bilateral total knee arthroplasty (SBTKA) and unilateral total knee arthroplasty (UTKA).
• To analyze trends in SBTKA utilization and outcomes from 2009 to 2016.

Main Methods:

• Utilized the National Inpatient Sample database to identify and analyze patients undergoing UTKA and SBTKA between 2009 and 2016.
• Compared demographic data, health status, length of stay (LOS), discharge disposition, hospital charges, costs, and complication rates between the two surgical approaches.

Main Results:

• SBTKA incidence decreased by 1.4% during the study period.
• The SBTKA cohort exhibited younger, healthier patients with higher rates of obesity and private insurance, but experienced longer LOS, increased discharges to skilled nursing facilities, higher costs, and more complications (DVT/PE, transfusions).
• SBTKA was associated with a lower rate of myocardial infarctions compared to UTKA.

Conclusions:

• Despite improvements, SBTKAs remain associated with increased LOS, higher costs, and a greater incidence of specific complications, including deep venous thrombosis/pulmonary embolism and transfusions.
• The comparative safety and efficacy of SBTKA versus staged UTKAs require further investigation to determine optimal patient management strategies.