Mortality and morbidity associated with simultaneous bilateral or staged bilateral total knee arthroplasty: a meta-analysis

Abstract

Objective: To evaluate the mortality and postoperative morbidity associated with simultaneous bilateral or staged bilateral total knee arthroplasty (TKA).

Methods: We identified eligible studies in PubMed (1980-2010), OVID MEDLINE (1980-2010) and the Cochrane library. Data were extracted and evaluated by two reviewers independently. Data analyses were conducted with Stata 10.0.

Results: Fourteen studies met our inclusion criteria. Combined results showed that the prevalence of mortality [OR = 3.202, 95% CI (1.852-5.537)], mortality at 30 days postoperatively [OR = 5.564, 95% CI (2.392-12.939)] and neurological complications [OR = 2.906, 95% CI (1.200-7.037)] were significantly higher in the population who had undergone simultaneous TKA compared with those who had undergone staged TKA. The prevalence of infection, pulmonary embolism, deep-vein thrombosis, and cardiac complications between the two populations was not significantly different.

Conclusion: Compared with staged bilateral TKA, simultaneous bilateral TKA might carry a higher potential risk of postoperative complications. Patients should be aware of this information when deciding whether to proceed with simultaneous bilateral TKA. The poor quality of the studies calls into question the robustness of the analyses.