Timing is Everything When Replacing Both Knee Joints

There are three ways to replace both knee joints when pain and disability of arthritis make life difficult. These are: staggered, sequential, and staged

Staggered: This involves a single hospital stay with both knee joints replaced one at a time, four to seven days apart.

Sequential: Both knee joints are replaced during a single operation.

Staged: One knee is operated on at a time. The surgeries are separated by weeks to months with two separate hospital stays.

In this study patients at the University of Iowa had both knees done using one of these three methods. The surgeons looked at the problems patients had after each type of surgery. They compared problems patients had after the operations. They also compared differences in payment by insurance companies with all three timing schedules. Reimbursement to the surgeon and to the hospital is both reported.

The authors reviewed complications for each type of surgery from previous studies done at other hospitals. Then they reported their own results as follows:

The rate of blood transfusion was three times higher in the staggered and sequential groups compared to the staged group.

The hospital stay was the shortest in the sequential group.

Patients who had a single hospital stay had twice as much rehab as the staged group.

The final conclusion was that having a staggered bilateral total knee replacement was safe and effective with few problems afterwards. Patients in this group have fewer problems. Reimbursement to the surgeons and hospitals is better with fewer costs to the patient.