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Higher Early Mortality with Simultaneous Rather than Staged Bilateral TKAs Results From the Swedish Knee Arthroplasty Register

Stefansdottir, Anna LU ; Lidgren, Lars LU and Robertsson, Otto LU (2008) In Clinical Orthopaedics and Related Research 466(12). p.3066-3070
Abstract
Patients with knee osteoarthritis (OA) often present with symptoms that warrant bilateral TKAs. There are potential benefits to operating on both knees on the same day, but the safety of simultaneous bilateral TKAs has been questioned. To evaluate whether there were any differences in 30-day mortality between patients having simultaneous bilateral TKAs and those having staged bilateral TKAs, we analyzed data from the Swedish Knee Arthroplasty Register and the Swedish Cause of Death Register. We included 48,931 patients with OA having 60,062 primary TKAs during 1985 to 2004; 1139 had surgery on both knees on the same day (simultaneous bilateral) and 3432 had surgery on both knees on two different occasions with less than 1 year between... (More)
Patients with knee osteoarthritis (OA) often present with symptoms that warrant bilateral TKAs. There are potential benefits to operating on both knees on the same day, but the safety of simultaneous bilateral TKAs has been questioned. To evaluate whether there were any differences in 30-day mortality between patients having simultaneous bilateral TKAs and those having staged bilateral TKAs, we analyzed data from the Swedish Knee Arthroplasty Register and the Swedish Cause of Death Register. We included 48,931 patients with OA having 60,062 primary TKAs during 1985 to 2004; 1139 had surgery on both knees on the same day (simultaneous bilateral) and 3432 had surgery on both knees on two different occasions with less than 1 year between operations (staged bilateral). The 30-day mortality after simultaneous bilateral TKAs was 7.53 (confidence interval, 2.62-21.69) times higher than after the second of staged TKA and 3.77 (confidence interval, 2.04-6.98) times higher than after a primary unilateral TKA. Assuming the total risk for a staged procedure is twice that of a unilateral procedure, the risk of mortality within 30 days is 1.94 (confidence interval, 1.05-3.59) times higher with simultaneous than staged TKA. It is safer to operate on one knee at a time. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Orthopaedics and Related Research
volume
466
issue
12
pages
3066 - 3070
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000261690500022
  • pmid:18670832
  • scopus:58149302911
ISSN
0009-921X
DOI
10.1007/s11999-008-0404-3
language
English
LU publication?
yes
id
3a033fb7-783a-41ff-a934-7fd4b59b8827 (old id 1383934)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18670832?dopt=Abstract
date added to LUP
2009-05-08 14:26:05
date last changed
2017-08-20 03:46:39
@article{3a033fb7-783a-41ff-a934-7fd4b59b8827,
  abstract     = {Patients with knee osteoarthritis (OA) often present with symptoms that warrant bilateral TKAs. There are potential benefits to operating on both knees on the same day, but the safety of simultaneous bilateral TKAs has been questioned. To evaluate whether there were any differences in 30-day mortality between patients having simultaneous bilateral TKAs and those having staged bilateral TKAs, we analyzed data from the Swedish Knee Arthroplasty Register and the Swedish Cause of Death Register. We included 48,931 patients with OA having 60,062 primary TKAs during 1985 to 2004; 1139 had surgery on both knees on the same day (simultaneous bilateral) and 3432 had surgery on both knees on two different occasions with less than 1 year between operations (staged bilateral). The 30-day mortality after simultaneous bilateral TKAs was 7.53 (confidence interval, 2.62-21.69) times higher than after the second of staged TKA and 3.77 (confidence interval, 2.04-6.98) times higher than after a primary unilateral TKA. Assuming the total risk for a staged procedure is twice that of a unilateral procedure, the risk of mortality within 30 days is 1.94 (confidence interval, 1.05-3.59) times higher with simultaneous than staged TKA. It is safer to operate on one knee at a time.},
  author       = {Stefansdottir, Anna and Lidgren, Lars and Robertsson, Otto},
  issn         = {0009-921X},
  language     = {eng},
  number       = {12},
  pages        = {3066--3070},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Clinical Orthopaedics and Related Research},
  title        = {Higher Early Mortality with Simultaneous Rather than Staged Bilateral TKAs Results From the Swedish Knee Arthroplasty Register},
  url          = {http://dx.doi.org/10.1007/s11999-008-0404-3},
  volume       = {466},
  year         = {2008},
}