Purpose: A staged bilateral total knee arthroplasty (BTKA) procedure is considered when a patient is not deemed suitable for simultaneous BTKA due to concerns about the risk of mortality and complications. However, no network meta-analysis has been conducted to compare simultaneous vs staged BTKA procedures with different intervals in terms of postoperative mortality and overall complication rates.
Methods: Four databases - Medline, Embase, Cochrane Library and Web of Science - were searched from inception to December 19, 2023, for studies comparing patients who underwent staged BTKA with different intervals and simultaneous BTKA. The primary outcome domains were 1-year mortality and 90-day overall complications. Secondary outcomes included neurological, cardiovascular, pulmonary, infectious and venous thromboembolic complications within 90 days.
Results: Fifteen observational studies were included. Staged BTKA with intervals between 6 weeks and 3 months (odds ratio (OR): 0.69, 95% CI: 0.53-0.91), between 3 and 6 months (OR: 0.67, 95% CI: 0.53-0.84) and longer than 6 months (OR: 0.67, 95% CI: 0.55-0.83) exhibited a lower mortality risk compared to simultaneous BTKA. Staged BTKA with an interval shorter than 6 weeks and longer than 6 months exhibited a higher risk of pulmonary (OR: 1.24, 95% CI: 1.03-1.49; OR: 1.64, 95% CI: 1.10-2.44) and infectious complications (OR: 1.50, 95% CI: 1.15-1.96; OR: 1.52, 95% CI: 1.14-2.02) compared to simultaneous BTKA. An interval between 3 and 6 months ranked best in outcomes of 1-year mortality (P score = 0.7849) and 90-day complications (P score = 0.7077).
Conclusions: Staged BKTA with an interval of more than 6 weeks but less than 6 months is associated with a lower risk of postoperative mortality and complications. However, these results should be interpreted with caution due to potential biases inherent in the inclusion of nonrandomized studies.
Level Of Evidence: II.
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Purpose: A staged bilateral total knee arthroplasty (BTKA) procedure is considered when a patient is not deemed suitable for simultaneous BTKA due to concerns about the risk of mortality and complications. However, no network meta-analysis has been conducted to compare simultaneous vs staged BTKA procedures with different intervals in terms of postoperative mortality and overall complication rates.
Methods: Four databases - Medline, Embase, Cochrane Library and Web of Science - were searched from inception to December 19, 2023, for studies comparing patients who underwent staged BTKA with different intervals and simultaneous BTKA.
Evolution and Hotspots in Bilateral Total Joint Arthroplasty Research: A Bibliometric Analysis.
Clin Orthop Surg
December 2024
Department of Orthopaedic Surgery, Brown University, Providence, RI, USA.
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- * A study analyzed 736 articles from 1982 to 2022 on BTJA, revealing that the U.S. is the leading contributor, with significant work from Cornell University and prominent author Kim YH.
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Comparison of the Cost-Effectiveness and Safety between Staged Bilateral Total Knee Arthroplasty and Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Cohort Study between 2001 and 2022.
J Knee Surg
November 2024
Department of Orthopaedics and Traumatology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
A substantial proportion of Hong Kong's aging population suffers from osteoarthritis in both knees. Bilateral total knee arthroplasty (BTKA) is a surgical option for addressing this condition and can be performed via two approaches: simultaneous BTKA (SimBTKA) and staged BTKA (StaBTKA). We compared the cost-effectiveness and safety of these two methods in our institution.
View Article and Find Full Text PDFAge-adjusted Charlson Comorbidity Index as an effective tool for the choice between simultaneous or staged bilateral total knee arthroplasty.
Arch Orthop Trauma Surg
August 2024
Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei, 112, Taiwan.
Introduction: The choice between simultaneous and staged bilateral total knee arthroplasty (BTKA) remains controversial. Age-adjusted Charlson Comorbidity Index(CCI) is a promising tool for risk-stratification. We aimed to compare the outcomes between patients who underwent simultaneous and staged BTKA, stratified by age-adjusted CCI scores.
View Article and Find Full Text PDFNo differences in terms of complications, readmissions, reoperations, and patient-reported outcomes in simultaneous bilateral versus staged bilateral total knee arthroplasty in selected patients.
Knee
March 2024
Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Rome, Italy; Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Background: The safety and the clinical success of simultaneous bilateral total knee arthroplasty (BTKA) is controversial. The aim of this study was to compare complications and patient-reported outcomes following simultaneous BTKA (simBTKA) versus staged BKTA (staBTKA) in patients affected by bilateral symptomatic end-stage knee osteoarthritis (OA).
Methods: Data from patients who underwent simBTKA or staBTKA at a single institution from January 2017 to December 2020, with a minimum 1-year follow up period were retrospectively collected.
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