naa a22 4500 510760155 CHVBK 20180411083136.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s11420-012-9315-7 doi (NATIONALLICENCE)springer-10.1007/s11420-012-9315-7 Simultaneous Versus Staged Bilateral Total Knee Arthroplasty [Elektronische Daten] A Meta-Analysis Evaluating Mortality, Peri-Operative Complications and Infection Rates [Nasir Hussain, Teresa Chien, Farrah Hussain, Ammar Bookwala, Nicole Simunovic, Vijay Shetty, Mohit Bhandari] Background: An important source of debate in many orthopaedic practices is the choice of performing simultaneous or staged bilateral total knee arthroplasty. Questions/Purpose: The objective of this meta-analysis is to compare simultaneous bilateral with staged bilateral total knee arthroplasty for peri-operative complication rates, infection rates and mortality outcomes. Methods: All relevant citations were retrieved from MEDLINE, EMBASE, COCHRANE databases and the unpublished literature. Included studies were assessed for methodological quality and abstracted data was conducted independently by two reviewers. Data was categorized into subgroups and pooled using the DerSimonian and Laird's random effects model. Results: A total of 18 articles were identified from 873 potentially relevant titles and selected for inclusion in the primary meta-analyses. The incidence of mortality was significantly higher in the simultaneous group at 30days (RR [relative risk] 3.67, 95% confidence interval [CI] 1.68-8.02, p = 0.001, I 2 = 59%, n = 67,691 patients), 3months (RR 2.45, 95% CI 2.15-2.79, p < 0.00001, I 2 = 0%, n = 66,142 patients) and 1year (RR 1.85, 95% CI 1.66-2.06, p < 0.001, I 2 = 0%, n = 65,322 patients) after surgery. However, there were no significant differences between the two groups in regards to in-hospital mortality rates (R 1.18, 95% CI 0.74-1.88, p = 0.48, I 2 = 0%, n = 33,814 patients). In addition, there was no increased risk of deep vein thrombosis, cardiac complication, and pulmonary embolism or infection rates in either comparison group. Conclusions: The results of the analysis suggest that simultaneous bilateral total knee arthroplasty has a significantly higher rate of mortality at 30days, 3months and 1year after surgery, but similar infection and complication rates in comparison to staged bilateral total knee arthroplasty. Hospital for Special Surgery, 2013 simultaneous or staged bilateral nationallicence total knee arthroplasty nationallicence meta-analysis nationallicence complication rates nationallicence infection nationallicence mortality nationallicence Hussain Nasir McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut Chien Teresa McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut Hussain Farrah McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut Bookwala Ammar McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut Simunovic Nicole McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut Shetty Vijay Hiranandani Orthopaedic Medical Education (HOME), Orthopaedic Division of Dr. LH Hiranandani Hospital, Powai, Mumbai, India aut Bhandari Mohit McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut HSS Journal ® Springer-Verlag 9/1(2013-02-01), 50-59 1556-3316 9:1<50 2013 9 11420 https://doi.org/10.1007/s11420-012-9315-7 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11420-012-9315-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hussain Nasir McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut NATIONALLICENCE 700 1- Chien Teresa McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut NATIONALLICENCE 700 1- Hussain Farrah McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut NATIONALLICENCE 700 1- Bookwala Ammar McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut NATIONALLICENCE 700 1- Simunovic Nicole McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut NATIONALLICENCE 700 1- Shetty Vijay Hiranandani Orthopaedic Medical Education (HOME), Orthopaedic Division of Dr. LH Hiranandani Hospital, Powai, Mumbai, India aut NATIONALLICENCE 700 1- Bhandari Mohit McMaster University, 293 Wellington Street North, Suite 110, L8L 8E7, Hamilton, Ontario, Canada aut NATIONALLICENCE 773 0- HSS Journal ® Springer-Verlag 9/1(2013-02-01), 50-59 1556-3316 9:1<50 2013 9 11420 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer