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MUSCULOSKELETAL SURGERY

Published in:

15-03-2021 | Original Article

Staggered bilateral total knee arthroplasty during a single hospitalization: is it still an option? a systematic review

Authors: M.-A. Malahias, A. Gu, I. De Martino, N. A. Selemon, M. P. Ast, P. K. Sculco

Published in: MUSCULOSKELETAL SURGERY | Issue 2/2022

Abstract

Background

Bilateral knee osteoarthritis requiring total knee arthroplasty (TKA) can be addressed simultaneously in one surgical setting, staggered a few days apart during a single hospitalization, or staged several weeks to months apart. Several studies have reported on the complications and clinical outcomes of staggered bilateral TKA (BTKA) in a single hospitalization. However, there is no consensus regarding the safety and efficacy of this practice.

Materials and methods

We performed a systematic review of the literature, utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and identifying articles that reported the clinical outcomes and postoperative complications following staggered BTKA.

Results

Overall, six articles were included for analysis, including 43,892 patients in total. Females (n = 25,931; 59% of all patients) outnumbered males (n = 17,961; 40.1% of all patients), and most patients were middle-aged or elderly (mean age: 68.0 years). The majority of studies (83%) used a 1-week interval as the maximum time for single-hospitalization staggered BTKA. Five studies (83%) reported no difference in mortality rates between staggered, simultaneous, or staged BTKA. Compared to staged BTKA, staggered BTKA conferred an increased rate of blood transfusions. There was no consensus that staggered BTKA led to reduced complications rates, compared to simultaneous or staged BTKA.

Conclusions

Single-hospitalization staggered BTKA does not appear to be safer than the well-established simultaneous or staged procedures. Overall, the data suggest that staggered BTKA will continue to decline in utilization, as staggered BTKA does not appear to yield clinical advantage over simultaneous BTKA in a medically appropriate patient.

Level of evidence III

systematic review (lowest level of studies included)

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Title: Staggered bilateral total knee arthroplasty during a single hospitalization: is it still an option? a systematic review
Authors: M.-A. Malahias
A. Gu
I. De Martino
N. A. Selemon
M. P. Ast
P. K. Sculco
Publication date: 15-03-2021
Publisher: Springer Milan
Published in: MUSCULOSKELETAL SURGERY / Issue 2/2022
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI: https://doi.org/10.1007/s12306-021-00696-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Staggered bilateral total knee arthroplasty during a single hospitalization: is it still an option? a systematic review

Abstract

Background

Materials and methods

Results

Conclusions

Level of evidence III

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

Level of evidence III

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