title: Bilateral Simultaneous vs Staged Total Knee Arthroplasty: A Comparison of Complications and Mortality.
abstract: The purpose of this study was to compare the complications and mortality between bilateral simultaneous total knee arthroplasty (BTKA-Simultaneous) and bilateral staged TKA (BTK-Staged) while adjusting for differences in patient, surgeon, and hospital characteristics.
  
  
  
  An integrated health care system total joint registry was used to compare patients undergoing BTKA-Simultaneous to BTKA-Staged. For outcomes related to revision and infection, the sample included 11,118 patients, and for outcomes of death, acute myocardial infarction, stroke, and venous thromboembolism, a subsample of 7991 patients with comorbidity data was selected.
  
  
  
  Overall death and complications in both groups were rare. The complication rates for BTKA-Simultaneous and BTKA-Staged were comparable: aseptic revision (1.17% vs 0.9%), septic revision/deep infection (0.8% vs 0.7%), death (0.28% vs 0.1%), and adverse events (2.49% vs 1.97%). In the adjusted models, there were no significant differences in any of the outcomes between the 2 groups.
  
  
  
  There is a lack of evidence to support superiority of either BTKA-Simultaneous or BTKA-Staged.
authors.affiliation: Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Irvine, California.
authors.forename: Dhiren S
authors.initials: DS
authors.lastname: Sheth
authors.affiliation: Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California.
authors.forename: Guy
authors.initials: G
authors.lastname: Cafri
authors.affiliation: Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Paxton
authors.affiliation: Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Irvine, California.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Namba
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019601:Pacific States / Q000453:epidemiology; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: bilateral; complications; propensity score; simultaneous; staged; total knee arthroplasty