This Article Full Text Full Text (PDF) CME: Take the activity for this article: CME 4: October, November, December 2003 [Supplementary Material] Letters to the Editor: Submit a response Letters to the Editor: View responses Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bullock, D. P. Articles by Shirreffs, T. G. Search for Related Content PubMed PubMed Citation Articles by Bullock, D. P. Articles by Shirreffs, T. G., Jr. Social Bookmarking                   What's this?

Comparison of Simultaneous Bilateral with Unilateral Total Knee Arthroplasty in Terms of Perioperative Complications

Investigation performed at the Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire

Daniel P. Bullock, BA
Scott M. Sporer, MD, MS
Thomas G. Shirreffs Jr., MD
Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

Background: Previous studies have demonstrated an increased rate of perioperative complications and morbidity following simultaneous bilateral total knee arthroplasty compared with the rate following unilateral total knee arthroplasty. The purpose of this study was to compare the rate of perioperative complications and morbidity associated with simultaneous bilateral total knee arthroplasty with that associated with unilateral total knee arthroplasty.

Methods: The records on all bilateral total knee arthroplasties performed between January 1994 and June 2000 and unilateral total knee arthroplasties performed between January 1995 and June 2000 were retrospectively reviewed. The records on 514 unilateral total knee arthroplasties and 255 bilateral total knee arthroplasties were analyzed to determine demographic information, preoperative comorbidities, perioperative complications, and thirty-day and one-year mortality rates.

Results: The rates of some perioperative complications, including myocardial infarction, postoperative confusion, and the need for intensive monitoring, were greater after the bilateral arthroplasties. However, the thirty-day and one-year mortality rates and the risks of pulmonary embolism, infection, and deep venous thrombosis were similar for the two groups.

Conclusions: The risk of perioperative complications associated with bilateral simultaneous total knee arthroplasty was slightly increased compared with that associated with unilateral total knee arthroplasty, but the mortality rates were similar. Ultimately, the decision to proceed with simultaneous knee replacement should depend on patient preference through informed choice.

Level of Evidence: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.

CiteULike    Connotea    Del.icio.us    Facebook    Technorati    Twitter    What's this?

This article has been cited by other articles:

				R. Fridman, J. D. Cain, L. Weil Jr, L. S. Weil Sr, and T. B. Ray Unilateral Versus Bilateral First Ray Surgery: A Prospective Study of 186 Consecutive Cases-Patient Satisfaction, Cost to Society, and Complications Foot & Ankle Specialist, June 1, 2009; 2(3): 123 - 129. [Abstract] [PDF]

				C. Restrepo, J. Parvizi, T. Dietrich, and T. A. Einhorn Safety of Simultaneous Bilateral Total Knee Arthroplasty. A Meta-Analysis J. Bone Joint Surg. Am., June 1, 2007; 89(6): 1220 - 1226. [Abstract] [Full Text] [PDF]

				J. Barrett, J. A. Baron, E. Losina, J. Wright, N. N. Mahomed, and J. N. Katz Bilateral Total Knee Replacement: Staging and Pulmonary Embolism J. Bone Joint Surg. Am., October 1, 2006; 88(10): 2146 - 2151. [Abstract] [Full Text] [PDF]

				J. R. M. Hutchinson, E. N. Parish, and M. J. Cross A comparison of bilateral uncemented total knee arthroplasty: SIMULTANEOUS OR STAGED? J Bone Joint Surg Br, January 1, 2006; 88-B(1): 40 - 43. [Abstract] [Full Text] [PDF]

Letters to the Editor:

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2003 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.