Risks and benefits of simultaneous bilateral total knee arthroplasty

Patients with symptomatic bilateral knee arthritis can elect to undergo simultaneous bilateral total knee arthroplasty, sameadmission staged bilateral total knee arthroplasty, or separateadmission staged bilateral total knee arthroplasty. The safety of simultaneous versus staged bilateral total knee arthroplasty (either during the same admission or during separate admissions) is debatable, with contradictory results reported in the literature. Selection bias, misclassification bias, and/or follow-up time bias are present in most studies comparing simultaneous bilateral total knee arthroplasty with other operative procedures. Simultaneous bilateral total knee arthroplasty may be preferred over same-admission or separate-admission staged bilateral total knee arthroplasty for reducing the risk of periprosthetic joint infection and surgical wound infections in individuals without cardiopulmonary disease or risk factors for venous thromboembolism.