The safety of simultaneous bilateral versus unilateral total knee arthroplasty: the experience in a Korean hospital

Shin YH, Kim MH, Ko JS, Park JA
Correspondence: Dr Myung Hee Kim, mhsmc.kim@samsung.com

ABSTRACT
Introduction The safety of simultaneous bilateral total knee arthroplasty (SBTKA) remains controversial. This study aimed to compare the postoperative outcomes of SBTKA versus unilateral total knee arthroplasty (UTKA) performed by a single surgeon at a tertiary teaching hospital in Korea.
Methods 629 female patients with total knee arthroplasty (308 patients for SBTKA and 321 for UTKA) performed under combined spinal epidural anaesthesia (CSE) were selected, and their medical records during admission and follow-up visits for a duration of six months after discharge were reviewed.
Results Although significantly higher incidences of postoperative confusion and hypoxia during hospitalisation and a longer hospital stay were demonstrated in the SBTKA group, the rates of serious postoperative complications, such as myocardial infarction and deep venous thrombosis, were not different between the groups during the hospital stay and six months afterwards. No death associated with the surgery was encountered in both groups.
Conclusion It was concluded that SBTKA under CSE may be considered to be relatively safe in Korean female patients.

Keywords: perioperative complications, simultaneous bilateral total knee arthroplasty, total knee arthroplasty, unilateral total knee arthroplasty
Singapore Med J 2010; 51(1): 44-49