Published: 2020-04-22

Comparison between simultaneous versus staged bilateral total knee arthroplasty: a prospective, randomized, controlled study

Rajesh Kumar Sharma, R. P. Meena


Background: Bilateral total knee arthroplasty (TKA) is a common procedure nowadays. Although, staging of surgery is a subject of debate. We conducted a study to compare safety and functional outcomes of simultaneous and staged bilateral TKA.

Methods: Our study includes total 70 patients of symptomatic severe bilateral osteoarthritis, underwent simultaneous or staged bilateral TKA during 2015 to 2019. 35 patients were randomly allotted for each procedure. The postoperative evaluations were done according to Knee Society Score at one, three, six and 12 months and yearly thereafter for 2 years following a simultaneous bilateral TKA (group A) and the second procedure in the staged bilateral TKA (group B).  In the staged group, the patients were followed at monthly intervals until the second procedure. The categorical variables were statistically significant when p value <0.05.

Results: As compared to staged procedure (group B), estimated blood loss was significantly less in simultaneous TKA (group A). Although, blood transfusion rate was significantly high in group A. The length of hospital stay was significantly shorter in group A. Overall complication rate (inpatient and/or 90 days readmission) was not significantly higher in group A. Knee infection rate was significantly lower in simultaneous TKA group. There was no revision of surgery and no mortality in any of our study group within 2 years of follow-up.

Conclusions: Simultaneous bilateral TKA is safe and cost-effective procedure with acceptable complication rates for bilateral symptomatic end stage knee osteoarthritis.


Bilateral total knee arthroplasty, Simultaneous, Staged, Knee society score

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