Early postoperative complications and blood transfusion risks in bilateral hip and knee arthroplasty: a retrospective...

This study assessed early complications and postoperative blood transfusion rates after simultaneous bilateral prosthetic hip or knee replacement.

Between 2020 and 2024, 285 patients underwent single-session bilateral total hip arthroplasty (THA), total knee arthroplasty (TKA), or unicompartmental knee arthroplasty (UKA) at a single referral centre. The cohort consisted of 102 patients in the TKA group, 83 in the THA group, and 100 in the UKA group. Patients were 57.2% male, with a mean age of 65.2 years ± 10.9 and a mean BMI of 27.9 ± 4.5. Based on the American Society of Anesthesiologists (ASA) classification, preoperative risk assessment showed a mean score of 1.8 ± 0.5. Early complications occurring within the first two postoperative months and anaemia requiring blood transfusion were recorded.

The early complication rate was 2.5% (7/285), with no complications in the UKA group, 5% (4/83) in the THA group, and 2% (2/100) in the TKA group. No deaths, deep venous thrombosis, pulmonary embolisms, or surgical site infections were reported. Complications included three periprosthetic fractures, one hip dislocation, one early unipolar revision for acetabular migration, and one extensor mechanism rupture. The transfusion rate was 4.6% (13/285), with no transfusions required in the UKA group, which was lower compared to THA (6%; 5/83) and TKA (8%; 8/100) (p = 0.02).

Single-stage bilateral hip and knee replacement prove to be a safe procedure with a low complication rate. UKA showed no early complications or transfusion needs, confirming its reliability as a safe option for single-stage bilateral procedures.