Mortality Rates in Staged Bilateral Total Knee Arthroplasty: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to assess the mortality rates of staged bilateral total knee arthroplasty (staBTKA) procedures. This systematic review followed the suggestions and recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. We performed a primary search in the PubMed, EBSCO, Scopus, Web of Science via Clarivate, and Google Scholar databases. A quantitative data synthesis was conducted to estimate the pooled prevalence of mortality among patients who underwent staBTKA using the MedCalc® Statistical Software version 20.115 (MedCalc Software Ltd., Ostend, Belgium). The Newcastle-Ottawa Scale was used for the quality assessment. The study included 29 studies with data from 115,348 patients. The mortality rate was estimated to be 0.34% (95% confidence interval: 0.18% to 0.55%). The data showed significant interstudy heterogeneity (I² = 93.3%). We used funnel plot inspection to visually assess significant publication bias, which showed a symmetrical distribution of the plotted data. Our study found that the mortality rates following staBTKA are relatively high. However, the reliability of our findings is limited due to significant heterogeneity. We recommend that further studies be conducted to provide higher-quality evidence to assess mortality in staBTKA and its trends.