title: Perioperative Outcomes Following Unilateral Versus Bilateral Total Knee Arthroplasty.
abstract: Simultaneous bilateral total knee arthroplasty (SB-TKA) is potentially a cost saving manner of caring for patients with bilateral symptomatic knee arthritis. We performed a retrospective analysis using the 2010-2012 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to evaluate the risk of perioperative complication following SB-TKA. Demographic characteristics, comorbidities, and 30-day complication rates were studied using a propensity score-matched analysis comparing patients undergoing unilateral TKA and SB-TKA. A total of 4489 patients met the inclusion criteria, of which 973 were SB-TKA. SB-TKA was associated with increased overall complications (P = 0.023), medical complications (P = 0.002) and reoperation (OR 2.12, P = 0.020). Further, total length of hospital stay (4.0 vs 3.4 days, P < 0.001) was significantly longer following bilateral surgery.
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Linda I
authors.initials: LI
authors.lastname: Suleiman
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Adam I
authors.initials: AI
authors.lastname: Edelstein
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Thompson
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Hasham M
authors.initials: HM
authors.lastname: Alvi
authors.affiliation: Department of Preventative Medicine, Division of Biostatistics, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Mary J
authors.initials: MJ
authors.lastname: Kwasny
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
authors.forename: David W
authors.initials: DW
authors.lastname: Manning
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology*; D057216:Propensity Score; D058996:Quality Improvement; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: complication; knee arthroplasty; outcomes; simultaneous; total knee arthroplasty