Controversy exists regarding the safety of simultaneous vs. staged bilateral total knee arthroplasty (TKA). The purpose of this study was to compare postoperative complication rate and clinical outcomes of simultaneous vs. staged bilateral TKA.
A consecutive series of 1074 patients who underwent either simultaneous (759 patients) or staged bilateral (315 patients) TKA from 2004 to 2013 were enrolled in this study. Postoperative complications were categorized as minor or major. Clinical outcome was evaluated at the last follow-up using Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and range of motion (ROM).
Major complication rate was not statistically different between the two groups. However, minor complication rate was significantly (p < 0.05) higher in the staged TKA group compared to that in the simultaneous TKA group. The median length of stay (LOS) in hospital was 18.0 days after simultaneous TKA vs. cumulated LOS of 34.1 days in the staged group (p < 0.05). Clinical outcome results revealed that there was no significant difference in KSS, WOMAC scores, or ROM between the two groups.
Therefore, simultaneous bilateral TKA has some advantage such as less length of stay in hospital compared to staged bilateral TKA. However, this procedure should be conducted very carefully, particularly in high-risk patients.