Simultaneous vs staged bilateral total knee arthroplasty: a propensity-matched case-control study from nine fast-track centres
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Simultaneous vs staged bilateral total knee arthroplasty : a propensity-matched case-control study from nine fast-track centres. / Lindberg-Larsen, M.; Pitter, F. T.; Husted, H.; Kehlet, H.; Jørgensen, C. C.; Lundbeck Foundation Centre for Fast-Track Hip and Knee Replacement Collaborative Group.
In: Archives of Orthopaedic and Trauma Surgery, Vol. 139, No. 5, 2019, p. 709-716.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Simultaneous vs staged bilateral total knee arthroplasty
T2 - a propensity-matched case-control study from nine fast-track centres
AU - Lindberg-Larsen, M.
AU - Pitter, F. T.
AU - Husted, H.
AU - Kehlet, H.
AU - Jørgensen, C. C.
AU - Lundbeck Foundation Centre for Fast-Track Hip and Knee Replacement Collaborative Group
PY - 2019
Y1 - 2019
N2 - INTRODUCTION: Limited data exist on patient safety after simultaneous vs staged bilateral total knee arthroplasty (TKA) in matched groups. Hence, the aim of this study was to compare length of stay (LOS), in-hospital complications, 30-day readmissions and mortality after simultaneous and staged bilateral TKA in matched patients.PATIENTS AND METHODS: A retrospective case-control study of prospectively collected data in nine centres from February 2010 to November 2015. Propensity scores (PS) were used to match simultaneous and staged (1-6 months between stages) bilateral TKA patients with prospectively collected patient characteristics from the Lundbeck Foundation Centre for Fast-track THA and TKA Database. 30-day follow-up was acquired from the Danish Patient Registry and patient records.RESULTS: A total of 344 (47.1%) simultaneous and 386 (52.9%) staged bilateral TKA procedures were performed. PS matching was possible in 232 simultaneous and 232 staged bilateral TKA patients. LOS was median 4 days (IQR 3-5) after simultaneous and cumulated 4 days (IQR 4-6) after staged procedures. The in-hospital complication rate was 15.5% after simultaneous vs 7.3% (p = 0.004) after staged procedures. Two cases (0.9%) of venous thromboembolic events were found in each group. Eight patients (3.4%) were re-operated after simultaneous vs one patient (0.4%) after staged bilateral TKA (p = 0.037). The 30-day readmission rate was 8.6% after simultaneous vs 5.6% after staged procedures (p = 0.281). No patients died in either group.CONCLUSIONS: We found no significant differences in 30-day readmission rates and mortality between simultaneous and staged bilateral TKA, but the in-hospital complication rate and re-operation rate was higher after the simultaneous procedure calling for further matched investigations in larger cohorts.
AB - INTRODUCTION: Limited data exist on patient safety after simultaneous vs staged bilateral total knee arthroplasty (TKA) in matched groups. Hence, the aim of this study was to compare length of stay (LOS), in-hospital complications, 30-day readmissions and mortality after simultaneous and staged bilateral TKA in matched patients.PATIENTS AND METHODS: A retrospective case-control study of prospectively collected data in nine centres from February 2010 to November 2015. Propensity scores (PS) were used to match simultaneous and staged (1-6 months between stages) bilateral TKA patients with prospectively collected patient characteristics from the Lundbeck Foundation Centre for Fast-track THA and TKA Database. 30-day follow-up was acquired from the Danish Patient Registry and patient records.RESULTS: A total of 344 (47.1%) simultaneous and 386 (52.9%) staged bilateral TKA procedures were performed. PS matching was possible in 232 simultaneous and 232 staged bilateral TKA patients. LOS was median 4 days (IQR 3-5) after simultaneous and cumulated 4 days (IQR 4-6) after staged procedures. The in-hospital complication rate was 15.5% after simultaneous vs 7.3% (p = 0.004) after staged procedures. Two cases (0.9%) of venous thromboembolic events were found in each group. Eight patients (3.4%) were re-operated after simultaneous vs one patient (0.4%) after staged bilateral TKA (p = 0.037). The 30-day readmission rate was 8.6% after simultaneous vs 5.6% after staged procedures (p = 0.281). No patients died in either group.CONCLUSIONS: We found no significant differences in 30-day readmission rates and mortality between simultaneous and staged bilateral TKA, but the in-hospital complication rate and re-operation rate was higher after the simultaneous procedure calling for further matched investigations in larger cohorts.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Arthroplasty, Replacement, Knee/adverse effects
KW - Case-Control Studies
KW - Clinical Protocols/standards
KW - Databases, Factual
KW - Female
KW - Humans
KW - Length of Stay
KW - Male
KW - Middle Aged
KW - Osteoarthritis, Knee/surgery
KW - Patient Readmission
KW - Perioperative Care/standards
KW - Propensity Score
KW - Registries
KW - Reoperation
KW - Retrospective Studies
KW - Time Factors
U2 - 10.1007/s00402-019-03157-z
DO - 10.1007/s00402-019-03157-z
M3 - Journal article
C2 - 30840128
VL - 139
SP - 709
EP - 716
JO - Archives of Orthopaedic and Trauma Surgery
JF - Archives of Orthopaedic and Trauma Surgery
SN - 0936-8051
IS - 5
ER -
ID: 225955514