Unilateral vs bilateral total knee arthroplasty risk factors increasing morbidity

J Arthroplasty. 2011 Aug;26(5):668-73. doi: 10.1016/j.arth.2010.07.011. Epub 2010 Sep 28.


Because surgeons are electing to perform simultaneous bilateral total knee arthroplasty (TKA), it is important to identify which patients are at increased risk. We performed a retrospective cohort analysis of 150 patients with unilateral TKA vs 150 patients with simultaneous bilateral TKA. The bilateral group demonstrated a 2.1 times greater mean overall complication rate as well as increased transfusion rates. Patients older than 70 years exhibited significantly higher complication rates. Having a preexisting pulmonary disorder in the bilateral cohort carried nearly a 3-fold risk of complications. Patients with body mass indices greater than 30 displayed a complication rate of 0.97 in the bilateral group as opposed to 0.44 in the control group. Our study demonstrated that age, body mass index, and a preexisting pulmonary disorder resulted in increased complications.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / methods*
  • Blood Transfusion / statistics & numerical data
  • Body Mass Index
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / surgery*
  • Lung Diseases / complications
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome