The risk of complications and rehospitalizations associated with simultaneous bilateral total knee arthroplasty may be greater than unilateral total knee arthroplasty in patients with bilateral osteoarthritis, according to a new study published by Richardson et al in The Journal of Bone & Joint Surgery. Investigators used the Premier Healthcare Database to identify 21,044 patients who underwent simultaneous bilateral total knee arthroplasty and 126,264 patients who underwent the unilateral procedure from 2015 to 2020. They then compared the rates of postoperative complications, hospital readmissions, and in-hospital mortality between the two groups. After 90 days of follow-up, patients who underwent simultaneous bilateral total knee arthroplasty had an increased risk of pulmonary embolism (adjusted odds ratio [OR] = 2.13, 95% confidence interval [CI] = 1.57–2.89), stroke (adjusted OR = 2.21, 95% CI = 1.42–3.42), acute blood loss anemia (adjusted OR = 2.06, 95% CI = 1.99–2.13), transfusion receipt (adjusted OR = 7.84, 95% CI = 7.16–8.59), and hospital readmission (adjusted OR = 1.35, 95% CI = 1.24–1.48) compared with those who underwent unilateral procedures. The investigators concluded that because of the greater risk of complications in patients who underwent simultaneous bilateral procedures, physicians considering this type of total knee arthroplasty should ensure that their patients receive counseling and thorough medical optimization.
July 20, 2023