title: [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].
abstract: 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.
authors.affiliation: Başkent Universitesi Tip Fakültesi, Ortopedi ve Travmatoloji Anabilim Dali, Adana. mhersekli@hotmail.com
authors.forename: Murat Ali
authors.initials: MA
authors.lastname: Hersekli
authors.forename: Sercan
authors.initials: S
authors.lastname: Akpinar
authors.forename: Metin
authors.initials: M
authors.lastname: Ozalay
authors.forename: Gürkan
authors.initials: G
authors.lastname: Ozkoç
authors.forename: Mustafa
authors.initials: M
authors.lastname: Uysal
authors.forename: Necip
authors.initials: N
authors.lastname: Cesur
authors.forename: Reha N
authors.initials: RN
authors.lastname: Tandoğan
mesh_terms: 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