Staging Bilateral Total Knee Arthroplasty During the Same Hospitalization: The Impact of Timing

The concept of staging during the same hospitalization for bilateral total knee arthroplasty (BTKA) has emerged as a practice to minimize perioperative risks, although with few data providing an evidence base. A total of 41,664 BTKA patients from Nationwide Inpatient Sample data between 1998 and 2010 were identified, and categorized into three groups, same day, staging 1–3 days, and staging 4–7 days BTKA. Staging BTKA 1–3 days apart was associated with increased rates for complications compared to same day BTKA, while staging 4–7 days BTKA was associated with similar complication profiles compared to same day BTKA. Our study suggests that same day BTKA for selective patient population is preferable, and staging BTKA either 1–3 days or 4–7 days apart should be discouraged.