Simultaneous, same-anaesthetic bilateral total knee arthroplasty has low mortality and complication rates

  • Eugene Wong
  • Chu Luan Nguyen
  • Sean Park
  • David Parker
Knee
  • 36 Downloads

Abstract

Purpose

The benefits of simultaneous bilateral total knee arthroplasty (SBTKR) include reduced hospital costs, single anaesthetic exposure and in many cases is also the patient’s preference. Despite these potential benefits, risk-adversity with respect to assumed complications and mortality make it difficult for the orthopaedic surgeon and patient to make an informed decision. This study aimed to address the inconsistencies and lack of consensus in previous literature regarding the short-term complications and clinical safety of SBTKR in patients with end-stage knee osteoarthritis (OA).

Methods

A cohort of 950 knees (475 patients) undergoing surgery between 2008 and 2013 was extracted from a prospectively collected clinical database and retrospectively linked to the Australian Joint Replacement Registry and hospital records. Patients underwent sequential SBTKR by their treating surgeon under one anaesthetic. Basic demographic data and outcome data including complications and mortality were collected. All data were analyzed using descriptive statistics only.

Results

A total of 413 patients and 826 knees were included. The average age of the cohort was 70 years with range between 46 and 88 years. 50% of patients were female. The overall mortality rate during the study follow-up period was 1.9%, with an average time to death postoperatively of 23.8 months. There were no cases of acute postoperative mortality (< 6 weeks). Medical complication rates were low.

Conclusions

In contrast to the higher mortality and complication rates suggested in previous literature, this study has demonstrated that SBTKR is safe, with low mortality and complication rates under the current surgical protocol.

Level of Evidence

IV.

Keywords

Simultaneous Bilateral Knee Arthroplasty Replacement Outcomes Staged 

Abbreviations

OA

Osteoarthritis

TKR

Total knee replacement

SBTKR

Simultaneous bilateral total knee replacement

NSLHD

Northern Sydney Local Health District

HREC

Human research ethics committee

HDU

High-dependency unit

AIHW

Australian institute of Health and Welfare

DVT

Deep vein thrombosis

PE

Pulmonary embolism

MI

Myocardial infarction

CVA

Cerebrovascular accident

CI

Confidence intervals

OR

Odds ratio

UTKR

Unilateral total knee replacement

StBTKR

Staged bilateral total knee replacement.

Notes

Author contributions

All authors (EW, CN, SP, DP) were involved in study design, collection of data, data analysis and manuscript preparation. All authors have read and approved the final manuscript for submission.

Compliance with ethical standards

Conflict of interest

All authors declare no conflicts of interest.

Ethical approval

Ethics approval for this retrospective study was granted following review by the Northern Sydney Local Health District Human Research Ethics Committee (NSLHD HREC Reference Number NSPHEC 2014-LNR-006).

Informed consent

For this type of study formal consent is not required.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  1. 1.Sydney Orthopaedic Research InstituteChatswoodAustralia
  2. 2.Royal North Shore HospitalSt LeonardsAustralia

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