title: Early morbidity after simultaneous and staged bilateral total knee arthroplasty.
abstract: OBJECTIVE
  The aim of this nationwide study was to investigate the early morbidity after bilateral simultaneous and staged total knee arthroplasty (TKA) in order to clarify potential benefits of a well-established fast-track regime.
  
  
  METHODS
  The Danish National Patient Registry was searched for all bilateral simultaneous and staged TKA procedures from 2010 to 2011. The staged procedures were defined as two separate procedures done within 0-6 months or within 7-18 months.
  
  
  RESULTS
  A total of 157 patients had bilateral simultaneous TKA, 346 patients had bilateral staged TKA within 0-6 months and 292 patients had bilateral staged TKA within 7-18 months. The median length of stay in hospital (LOS) was 4 days (interquartile range, IQR: 3) after bilateral simultaneous TKA versus cumulated LOS of 6 days (IQR: 3) in both of the bilateral staged groups (p < 0.001). There were no deaths after bilateral simultaneous TKA versus three deaths (0.9 and 1.0 %) in each of the bilateral staged groups within 90 days of surgery (n.s.). The total readmission rate within 30 days of surgery was lower after bilateral simultaneous TKA (7 %, CI 4.0-12.0) and bilateral staged TKA within 0-6 months (9 %, CI 6.4-12.4) compared with 14 % (CI 11.5-20.1) after bilateral staged TKA within 7-18 months.
  
  
  CONCLUSIONS
  The results from this nationwide study indicate that bilateral simultaneous TKA can safely be performed in a fast-track set-up.
authors: Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark, martinl@dadlnet.dk.
authors: Martin
authors: M
authors: Lindberg-Larsen
authors: Christoffer C
authors: CC
authors: Jørgensen
authors: Henrik
authors: H
authors: Husted
authors: Henrik
authors: H
authors: Kehlet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010359:Patient Readmission; D012042:Registries; D012189:Retrospective Studies