Outpatient Simultaneous Bilateral Total Knee Arthroplasty: Is It Safe?

It is currently unknown if simultaneous bilateral total knee arthroplasty (si-BTKA) can also be safely performed in the outpatient setting. The primary aim of this study was to compare 30-day postoperative complication rates between outpatient and inpatient si-BTKA.

Adults undergoing simultaneous bilateral total knee arthroplasty (si-BTKA) from 2015-2019 were queried using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Our primary analysis compared the rates of complications between outpatient si-BTKA and inpatient si-BTKA using bivariate comparisons and multivariable logistic regression of outpatient and inpatient cases controlling for differences in baseline demographics and comorbidities.

From 2015 to 2019, the utilization of outpatient si-BTKA increased from 0.6% to 10.5%. Outpatient si-BTKA were found to have significantly lower odds of any complication (OR = 0.49), minor complication (OR = 0.50), and postoperative transfusion (OR = 0.66) compared to inpatient cases. Outpatient si-BTKA also had a significantly shorter operative time.

Compared to inpatient si-BTKA, patients who undergo outpatient si-BTKA do not demonstrate increased rates of any complication, severe complications, and minor complications within 30-days postoperatively. Further insight is needed on the effect of outpatient si-BTKA on long-term outcomes.