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Attaining neutrality in all three alignments is important in maximizing total knee implant survival. Substantial "correction" of the alignment of one component in order to compensate for malalignment of the other component and thus produce a neutrally aligned total knee replacement can increase the risk of failure (p = 0.0082). The use of conventional guides to align a total knee replacement provides acceptable alignment; however, the surgeon should be aware that the patient's size, as determined by the BMI, is also a major factor in total knee replacement failure.

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Background: The present study aimed at determining the incidence of deep venous thrombosis (DVT) in 2 groups of patients who underwent simultaneous bilateral total knee arthroplasty (BTKA) or staged bilateral TKA. Methods: Patients with bilateral knee osteoarthritis, who were candidates for BTKA, were divided into 2 groups of patients undergoing either simultaneous bilateral or staged TKA. Incidence of DVT was measured during a 38-month follow-up period and compared between the 2 groups.