Staging Bilateral Total Knee Arthroplasty During the Same Hospitalization: The Impact of Timing.
The concept of staging during the same hospitalization for bilateral total knee arthroplasty (BTKA) has emerged as a practice to minimize perioperative risks, although with few data providing an evidence base. A total of 41,664 BTKA patients from Nationwide Inpatient Sample data between 1998 and 2010 were identified, and categorized into three groups, same day, staging 1-3 days, and staging 4-7 days BTKA. Staging BTKA 1-3 days apart was associated with increased rates for complications compared to same day BTKA, while staging 4-7 days BTKA was associated with similar complication profiles compared to same day BTKA. Our study suggests that same day BTKA for selective patient population is preferable, and staging BTKA either 1-3 days or 4-7 days apart should be discouraged.
Department of Anesthesiology and Critical Care, the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Orthopaedic Surgery, the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Jiabin
J
Liu
Department of Anesthesiology and Critical Care, the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Orthopaedic Surgery, the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Nabil
N
Elkassabany
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
Lazaros
L
Poultsides
Department of Orthopaedic Surgery, the Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Charles L
CL
Nelson
Department of Anesthesiology, Hospital for Special Surgery, New York, New York.
Stavros G
SG
Memtsoudis
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
bilateral total knee arthroplasty; morbidity; same hospitalization; staging; timing