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. 2024 Dec 2;14(1):29987.
doi: 10.1038/s41598-024-81821-0.

Complications following bilateral simultaneous versus staged total knee arthroplasty in the Japanese population: a propensity-matched case-control study

Yosuke Matsumura  1 , Masanori Fujii  2 , Yuichi Yamaguchi  1 , Satomi Nagamine  1 , Tatsuya Sakai  1 , Shuya Ide  3 , Tomonori Tajima  4 , Takafumi Shimazaki  5 , Shuichi Eto  6 , Masaaki Mawatari  1
Affiliations

Complications following bilateral simultaneous versus staged total knee arthroplasty in the Japanese population: a propensity-matched case-control study

Yosuke Matsumura et al. Sci Rep. .

Abstract

Although bilateral simultaneous total knee arthroplasty (BSTKA) is an effective treatment for bilateral knee osteoarthritis, safety concerns and lack of precise patient selection criteria persist. This study aimed to determine the differences in perioperative parameters and complication rates between BSTKA and staged TKA in the Japanese population. We retrospectively reviewed 531 patients who underwent BSTKA or staged TKA between 2012 and 2021. Propensity score matching, performed on a 1:1 nearest neighbor basis for age, BMI, diagnosis, ASA score, and age-adjusted Charlson Comorbidity Index, yielded matched cohorts of 94 patients (188 knees) for each group. Outcome measures included operative time, perioperative blood loss, length of hospital stay, and nonmechanical complications after surgery. The BSTKA group had a shorter median operative time and hospital stay (111 min and 16 days) than the staged TKA group (159 min and 33 days) (p < 0.001). Overall complication rates were higher in the BSTKA group than in the staged TKA group (26% vs. 13%, p = 0.026), with anemia requiring transfusion being the most common. Cardiovascular complications were more frequent in the BSTKA group (4.3% vs. 0%, p = 0.043). These findings emphasize the importance of careful patient selection and risk assessment when considering BSTKA.

Keywords: Bilateral simultaneous; Complications; Propensity score matching; Total knee arthroplasty.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethical approval: Each author certifies that his/her institution approved the human subject protocol for this investigation and that all investigations were conducted in conformity with the 1964 Helsinki Declaration. Ethical approval for this study was obtained from the institutional ethical review board of the Faculty of Medicine, Saga University (No. 2022-07-R-04), and the requirement for informed consent of the participants was waived by the institutional ethical review board of the Faculty of Medicine, Saga University, due to the retrospective nature of the study. Consent to participate: Ethical approval for this study was obtained from the Faculty of Medicine, Saga University (No. 2022-07-R-04).

Figures

Fig. 1
Fig. 1
A STROBE flow diagram of this study is shown.
See this image and copyright information in PMC

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