Simultaneous bilateral total knee arthroplasty tied to increased rates of postoperative complications
USA: A recent study published in the Journal of Bone & Joint Surgery has found an association between simultaneous bilateral total knee arthroplasty (TKA) and increased risk of postoperative complications, including stroke, pulmonary embolism, and transfusion.
"Orthopedic surgeons and patients should consider these potential complications when contemplating simultaneous bilateral TKA. When simultaneous bilateral TKA is pursued, medical optimization and patient counseling should be performed," according to the report by Nathanael D. Heckmann, MD, and colleagues of Keck School of Medicine of USC, Los Angeles.
Study in matched groups of patients clarifies risks of bilateral TKA
TKA is a highly effective treatment for patients with advanced osteoarthritis of the knee, decreasing pain and improving function. When both knees are affected, bilateral TKA offers some advantages over sequential unilateral TKA, including less time in the hospital, a single rehabilitation period, and lower overall costs.
However, some studies have found an increased risk of complications, along with a higher mortality rate, in patients undergoing bilateral TKA. These studies have had important limitations, including a lack of patient matching to account for potential differences between those undergoing bilateral versus unilateral TKA. To address these issues, Dr. Heckmann and colleagues compared complications and mortality in a large, nationally representative group of patients undergoing bilateral versus unilateral TKA.
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