Simultaneous Versus Staged Total Knee Arthroplasty (TKA)

Shahcheraghi, Gholam Hossain

doi:10.22034/ijos.2024.228146

Simultaneous Versus Staged Total Knee Arthroplasty (TKA)

Editor-in-Chief Lecture

Author

Gholam Hossain Shahcheraghi

Shiraz University of Medical Sciences

https://doi.org/10.22034/ijos.2024.228146

Abstract

There has been significant on-going debate on doing bilateral TKA either under a single anesthesia or staging the surgery (replacement on the contralateral knee within maximum of one year following the first knee)⁽¹⁾. There are proponents of both techniques.
{The term staggered TKA refers to replacement on the same period of hospitalization, but not on a single anesthesia⁽²⁾ and there is not much literature support for that).
Around 30% of patients who undergo unilateral TKA have enough symptoms -both in terms of pain and functional impairments, to require contralateral replacement within 10 years⁽³⁾.
The controversy of simultaneous versus staged bilateral TKA can be looked at in 4 different categories:

Which technique would be more economic and what is the cost-effectiveness?
Functional achievements: which one has better functional outcome?
Complications, morbidity and mortality rate: which one is safer?
What percentage of patients and for how long after first TKA, would not need contralateral TKA?

Subjects