Abstract
Introduction: The safety of simultaneous bilateral knee replacement (BTKA) remains controversial. Some studies have proposed a higher incidence of serious complications, even death, following BTKA whilst others refute the latter. The objective of this meta-analysis was to evaluate the safety of BTKA.
Methods: A computerized literature search was conducted to identify all citations, between 1966 to 2005, concerning BTKA. All the English-language abstracts were obtained. A multistage assessment was then used to identify articles fulfilling the inclusion criteria for the study. All randomized, prospective studies reporting the outcome of BTKA were included. Details of any reported data were extracted and extensive analysis of relevant variables carried out.
Results: 150 published articles pertaining to BTKA were identified of which 18 papers on 27,807 patients (44,684 knees) were included in the meta-analysis.10,734 cases were unilateral TKA, 16,378 were simultaneous BTKA and 458 were staged bilateral TKA with at least 3 months time duration between the surgical procedures. The complications analyzed were DVT, PE, cardiac events and mortality. The incidence of PE (OR=1.8), cardiac complications (OR=2.4), and mortality (OR=2.24) were higher after simultaneous BTKA. The incidence of DVT was LOWER in the group with simultaneous BTKA.
Discussion: Based on the findings of this meta-analysis, simultanous BTKA seems to carry a higher risk of serious cardiac complications, pulmonary complications, and mortality. This procedure should be reserved for the healthy and young patients.
Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland
