DOS 2017

· DOS Abstracts

Simultaneous versus staged bilateral total knee arthroplas-

ty. A propensity matched case-control study from 9 fast-

track centres.

Martin Lindberg-Larsen, Frederik Taylor Pitter, Henrik Husted, Henrik Kehlet, Christoffer

Jørgensen

Department of Orthopaedic Surgery, Odense University Hospital and The Lundbeck

Centre for Fast-track Hip and Knee Arthroplasty; Section of Surgical Pathophysiology

and The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen Univer-

sity Hospital Rigshospitalet; Department of Orthopaedic Surgery, Copenhagen Universi-

ty Hospital Hvidovre and The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty;

Section of Surgical Pathophysiology and The Lundbeck Centre for Fast-track Hip and

Knee Arthroplasty, Copenhagen University Hospital Rigshospitalet; Section of Surgical

Pathophysiology and The Lundbeck Centre for Fast-track Hip and Knee Arthroplasty,

Copenhagen University Hospital Rigshospitalet

Background:

Bilateral simultaneous total knee arthroplasty (TKA) seems safe in selected

patients[1]. However, limited data exists on postoperative morbidity compared to staged

bilateral procedures and there are no randomized controlled trials. [1] Lindberg-Larsen M

et al. Knee Surg Sports Traumatol Arthrosc 2015, 23: 831-7.

Purpose / Aim of Study:

To compare early postoperative morbidity, mortality and

length of stay (LOS) between bilateral simultaneous and staged TKA in matched groups.

Materials and Methods:

A prospective propensity score matched case-control study

in 9 dedicated high-volume centers from Feb. 2010 to Nov. 2015. Bilateral simultane-

ous and staged TKA (1-6 months between stages) were matched on available patient

characteristics in the Lundbeck Foundation Centre for Fast-track THA and TKA Database.

30-days follow-up was acquired from the Danish Patient Registry and patient records.

Findings / Results:

A total of 345 (47.2%) simultaneous and 386 (52.8%) staged bi-

lateral TKA procedures were performed. In non- matched analysis 30 day readmission

rate was 7.2% after simultaneous vs 8.0% after staged bilateral procedures (ns). No

patients died within 30 days postoperatively. 235 simultaneous and 235 staged bilateral

TKA patients were matched and LOS was median 4 days (IQR 3-5) after simultaneous vs

cumulated 4 days (IQR 4-6) after staged bilateral TKA (p<0.001). 30 day readmission

rate was 8.5% after simultaneous vs 8.1% after staged bilateral TKA (ns). Only 2 cases

(0.9%) of venous thromboembolic events were found in each of the groups. 4 cases

(1.7%) of deep infections requiring revision were found after simultaneous and none

after staged bilateral TKA (ns).

Conclusions:

Early postoperative morbidity, mortality and LOS may be similar between

simultaneous and staged bilateral TKA procedures but further safety data on specific

complications is required.

No conflicts of interest reported