[A comparison between single- and two-staged bilateral total knee arthroplasty operations in terms of the amount of blood loss and transfusion, perioperative complications, hospital stay, and cost-effectiveness].

Abstract

We compared bilateral total knee arthroplasty (TKA) operations performed at a single session or at two separate sessions with respect to perioperative complications, the amount of blood loss and transfusion, the length of hospital stay, and the overall cost. The study included 39 patients (34 females, 5 males; mean age 68.1 years; range 52 to 88 years) and 16 patients (13 females, 3 males; mean age 66.8 years; range 52 to 83 years) who underwent bilateral TKA for osteoarthritis at a single session and at two separate sessions, respectively. Staged operations were interspersed with a mean interval of 8.3 months (range 2 to 24 months). The two groups were compared with respect to perioperative complications, the amount of blood loss and transfusion, the length of hospitalization, and the overall cost. The amount of blood loss and transfusion, the length of intensive care unit stay, and the occurrence of perioperative complications did not differ significantly between single- and two-staged operations (p>0.05). However, the mean length of hospital stay (10.48 days versus 17.19 days; p=0.01) and the mean overall cost (p=0.03) were significantly less in single-staged operations. Perioperative complications accounted for 12.8% (n=5) and 25% (n=4) in single- and two-staged operations, respectively, all of which developed in patients who had a preexisting cardiologic disease. In view of its advantages, single-staged bilateral TKA seems to be an appropriate alternative in selected patients.