Abstract
The proportion of bilateral total knee replacements (BTKR) to unilateral total knee
replacement (UTKR) in the United States is increasing. From 1990 to 2004, the use
of BTKRs more than doubled for the entire civilian population and almost tripled among
the female population. BTKRs can be performed in a single-stage or a staged procedure.
Supporters of single-stage BTKR point out its low complication rates, high patient
satisfaction, and cost-effectiveness. Others strongly believe that BTKR performed
during the same anesthetic session is associated with increased morbidity and mortality.
Single-stage BTKR surgery aims at reducing the exposure to repeated anesthesia, total
hospitalization and recovery time, and cost, while maintaining patient safety and
reducing the negative clinical and functional outcomes observed in patients undergoing
UTKR or staged BTKR. This article presents the current concepts and controversies
around BTKR surgery based on the authors' body of research and a review of the literature.
We also present our institutional guidelines for candidates for single-stage BTKR.
Keywords
bilateral knee replacement - bilateral TKA - bilateral TKA guidelines - single-stage
bilateral TKA
