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Same-day bilateral total knee replacement versus unilateral total knee replacement: A comparative study.

Antoine Raffaelli1, Yoann Lévy1, Pascal Boileau2

  • 1Service de Chirurgie Orthopédique-Traumatologique-Chirurgie Vertébrale, Institut Universitaire Locomoteur et du Sport, CHU de Nice, Hôpital Pasteur 2, 30, voie Romaine, 06100 Nice, France.

Orthopaedics & Traumatology, Surgery & Research : OTSR
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PubMed
Summary
This summary is machine-generated.

Same-day bilateral total knee arthroplasty (TKA) in selected patients showed fewer early complications than unilateral TKA. This study found no increase in late complications, implant survival, or patient satisfaction for bilateral TKA.

Keywords:
Bilateral total knee arthroplastyFunctional scoresKnee osteoarthritisPostoperative complicationsSame-daySatisfactionUnilateral total knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Arthroplasty
  • Biomedical Engineering

Background:

  • Bilateral total knee arthroplasty (TKA) performed in a single session is uncommon due to perceived risks.
  • This study investigates the safety and efficacy of same-day bilateral TKA compared to unilateral TKA.

Purpose of the Study:

  • To compare complication rates between same-day bilateral TKA and unilateral TKA in patients under 80 with ASA scores of 1 or 2.
  • To evaluate implant survival, functional outcomes, and patient satisfaction.

Main Methods:

  • Retrospective comparative study of 91 bilateral TKAs and 182 unilateral TKAs (2009-2016).
  • Patients were matched by age, sex, indication, and ASA score, with a minimum 2-year follow-up.
  • Outcomes included mortality, early/late complications, implant survival, and functional scores (KOOS, New IKS).

Main Results:

  • Early complication rates were significantly lower in the bilateral TKA group (9%) versus unilateral TKA (22%).
  • No significant differences were observed in late complications, 5-year implant survival (99% vs. 97%), or patient satisfaction.
  • Autologous blood transfusion rates were higher in the bilateral TKA group (33% vs. 2.2%).

Conclusions:

  • Same-day bilateral TKA in selected patients (ASA 1-2, <80 years) did not increase the overall complication rate compared to unilateral TKA.
  • The procedure demonstrated favorable early outcomes and comparable long-term results.
  • While transfusion rates were higher, functional outcomes and patient satisfaction were similar between the groups.