[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].
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
In view of its advantages, single-staged bilateral TKA seems to be an appropriate alternative in selected patients.
Hersekli
Murat Ali
MA
Başkent Universitesi Tip Fakültesi, Ortopedi ve Travmatoloji Anabilim Dali, Adana. mhersekli@hotmail.com
Akpinar
Sercan
S
Ozalay
Metin
M
Ozkoç
Gürkan
G
Uysal
Mustafa
M
Cesur
Necip
N
Tandoğan
Reha N
RN
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000453:epidemiology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D014421:Turkey / Q000453:epidemiology