The Patient's Age and American Society of Anesthesiologists Status Are Reasonable Criteria for Deciding Whether to Perform Same-Day Bilateral TKA

J Arthroplasty. 2015 May;30(5):770-5. doi: 10.1016/j.arth.2014.12.004. Epub 2014 Dec 5.

Abstract

We investigated whether basing a decision to perform same-day bilateral TKA (SD BTKA) on the patient's age and American Society of Anesthesiologists (ASA) status was reasonable. We retrospectively reviewed the records of 1386 patients who underwent 2086 TKAs (686 unilateral TKAs [UTKAs], 1038 SD BTKAs, and 362 one-week staged BTKAs). For the entire cohort, patients undergoing SD BTKA had a higher risk of major complications compared to those undergoing UTKA. However, there was no difference in the incidence of complications for patients aged<75 years with an ASA status of 1 or 2 who underwent UTKA or SD BTKA. If patients are selected based on age and ASA status, SD BTKA may have a risk of postoperative complication similar to UTKA.

Keywords: American Society of Anesthesiologist classification; postoperative complication; same-day bilateral total knee arthroplasty; staged bilateral total knee arthroplasty; unilateral total knee arthroplasty.

MeSH terms

  • Adult
  • Age Factors*
  • Aged
  • Aged, 80 and over
  • Anesthesiology / standards
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Arthroplasty, Replacement, Knee / methods*
  • Cohort Studies
  • Decision Making
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Societies, Medical
  • United States