Incidence of postoperative complications of simultaneous bilateral total knee arthroplasty in relation to American Society of Anesthesiologists risk scoring, pilot study

Introduction: As a procedure, simultaneous bilateral total knee arthroplasty (SB-TKA) has not received its acceptance into routine clinical practice yet; perhaps, due to concerns regarding higher rates of perioperative complications associated with it as compared to the conventional unilateral procedure. The objective of the current study is to assess the safety of SB-TKA in relation to the American Society of Anesthesiologists (ASA) score and to assess the incidence of postoperative complications. Materials and Methods: In a prospective study, 25 patients underwent SB-TKA between January 2011 and April 2014. The inclusion criteria comprised patients with bilateral end-stage primary osteoarthritis of knees interfering with daily activities. A well-defined pre-determined protocol for pre- and postoperative care was adhered. Results: The study included 8 male and 17 female patients. Mean age of the patients was 66.4 ± 8.3 years. Five cases were classified as ASA-1 (20%), 11 cases as ASA-2 (44%) and 9 cases as ASA-3 (36%). No death, deep venous thrombosis, pulmonary embolism or neurological injury was reported in any of our patients postoperatively. One patient developed chest congestion on day 2 and was treated conservatively. One patient suffered from non-ST-segment elevation myocardial ischaemia on day 3 and was treated uneventfully. Two patients had a minor complication in the form of wound infection. No statistical relation was found between ASA risking score and postoperative complications. Conclusion: SB-TKA is a safe procedure if done after careful selection of patients in addition to a proper pre- and postoperative management protocol.