A Population-Based Comparison of the Incidence of Adverse Outcomes After Simultaneous-Bilateral and Staged-Bilateral Total Knee Arthroplasty

Meehan, John P.; Danielsen, Beate; Tancredi, Daniel J.; Kim, Sunny; Jamali, Amir A.; White, Richard

doi:10.2106/jbjs.j.01350

Cited by 130 publications

(106 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prior research has shown that the overall incidence of procedure-related complications was lower after same-day compared to staged bilateral TKAs during a single hospitalization [18]. Likewise, a recent analysis [14] suggested, after risk adjustment, the odds of developing hematoma and infection were lower in patients undergoing same-day bilateral TKAs than in patients undergoing staged bilateral TKAs.…”

Section: Discussionmentioning

confidence: 99%

“…Data have shown a decrease in 30-day mortality after sameday bilateral TKAs from 0.99% in 1990 [24] to 0.38% in 2007 [14]. However, despite potential advantages of the same-day approach, including exposure to the risks of anesthetic only once, one postoperative course of pain, reduced rehabilitation, and an earlier return to baseline function [10,11,23], the safety of same-day procedures has been questioned because of higher morbidity and mortality when compared with unilateral TKAs [15,22].…”

Section: Introductionmentioning

confidence: 99%

“…However, despite potential advantages of the same-day approach, including exposure to the risks of anesthetic only once, one postoperative course of pain, reduced rehabilitation, and an earlier return to baseline function [10,11,23], the safety of same-day procedures has been questioned because of higher morbidity and mortality when compared with unilateral TKAs [15,22]. Several studies have attempted to compare the incidence of complications after same-day bilateral TKAs, staged bilateral TKAs, and unilateral TKAs using single institution databases, large administrative datasets, or meta-analyses [1,6,7,9,14,15,18,22,[26][27][28]. However, there are no randomized trials comparing the safety of these surgical strategies.…”

Section: Introductionmentioning

confidence: 99%

“…However, there are no randomized trials comparing the safety of these surgical strategies. Because of the diversity of study settings and designs, it is difficult to draw definitive conclusions [1,6,7,9,14,15,18,22,[26][27][28].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Perioperative Morbidity and Mortality of Same-day Bilateral TKAs: Incidence and Risk Factors

Poultsides

Memtsoudis

Valle

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Controversy persists regarding the safety of same-day bilateral TKAs, and indications for same-day versus staged bilateral surgery need to be clarified. Questions/purposes We compared the (1) 30-day mortality, (2) rates of in-hospital complications, (3) in-hospital charges, and (4) risk factors for complications among patients undergoing same-day and staged bilateral TKAs at two separate admissions within 1 year either less than 3 months apart (staged 0-3) or more than 3 months apart (staged 3-12) at an institution where same-day bilateral TKAs were discouraged in patients with more severe medical comorbidities. Methods We analyzed institutional data from 3960 sameday, 172 staged 0-3, and 1533 staged 3-12 bilateral TKAs performed between 1998 and 2011. Patient demographics, comorbidities, and 30-day mortality were tabulated. Sameday patients were younger and healthier. Outcomes of interest included complications, blood transfusions, transfer to rehabilitation, and in-hospital charges. Regression models were conducted to identify independent risk factors for major morbidity or mortality. Results There were no differences in 30-day mortality among groups. The same-day group experienced more acute postoperative anemia, blood transfusions, and transfers to rehabilitation, but otherwise had complications comparable to those of the staged groups. In-hospital charges were lower in the same-day group. Congestive heart failure and pulmonary hypertension were the most significant factors associated with morbidity and mortality in the same-day group. Conclusions In a high-volume subspecialty setting in which patients undergoing same-day bilateral TKAs were generally much healthier and younger, we found that sameday bilateral TKAs appeared to be safe.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Perioperative Morbidity and Mortality of Same-day Bilateral TKAs: Incidence and Risk Factors

Poultsides

Memtsoudis

Valle

et al. 2014

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…1). Patients undergoing bilateral joint arthroplasties were excluded because of greater complication rates and these patients were deemed not directly comparable to patients with cirrhosis undergoing unilateral joint arthroplasties [17,21]. Patients with different states of residence and hospitalization in the database were excluded because if complications were to occur, these patients may not return to the original state for treatment.…”

Section: Patient Selectionmentioning

confidence: 99%