ReviewHSS journal : the musculoskeletal journal of Hospital for Special Surgery2013
Simultaneous versus staged bilateral total knee arthroplasty: a meta-analysis evaluating mortality, peri-operative complications and infection rates.
Review in HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03792828 (Pre-emptive Effect of Duloxetine in the Second Knee in Staged Total Knee Arthroplasty), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pre-emptive Effect of Duloxetine in the Second Knee in Staged Total Knee Arthroplasty: A Randomized Controlled Study
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Staggered bilateral total knee arthroplasty during a single hospitalization: is it still an option? a systematic review.Musculoskeletal surgery · 2022Pooled it
- Risk factors associated with cardiac complication after total joint arthroplasty of the hip and knee: a systematic review.Journal of orthopaedic surgery and research · 2019Pooled it
- Local Efficacy of Corticosteroids as an Adjuvant for Periarticular Cocktail Injection in Simultaneous Bilateral Total Knee Arthroplasty: A Prospective Randomized Double-Blind Controlled Trial.Pain research & management · 2021Trial
- Safety of one-stage bilateral total knee arthroplasty -one surgeon sequential vs. two surgeons simultaneous: a randomized controlled study.International orthopaedics · 2020Trial
- Association of interstage timing and prior surgical response with outcomes following staged bilateral total knee arthroplasty: A retrospective cohort study.Journal of experimental orthopaedics · 2026Article
- Simultaneous bilateral total knee arthroplasty lowers reoperation and cost at the expense of higher complications and mortality: a meta-analysis and systematic review.Knee surgery & related research · 2025Review
- Simultaneous Bilateral Total Knee Arthroplasty in a Post-Traumatic Osteoarthritis Patient: A Case Report and Literature Review.Clinical case reports · 2025Article
- Optimal timing for bilateral total knee arthroplasty: comparing simultaneous and staged procedures at various intervals: a systematic review and network meta-analysis.EFORT open reviews · 2025Article
- Emergency-Driven Multiple Simultaneous Invasive Procedures in Haemophilia.Life (Basel, Switzerland) · 2024Article
- Subsequent total joint arthroplasty: Are we learning from the first stage?World journal of orthopedics · 2024Article
- Is sequential bilateral robotic total knee arthroplasty a safe procedure? A matched comparative pilot study.Archives of orthopaedic and trauma surgery · 2023Article
- Article
- Cost analysis of staged versus simultaneous bilateral total knee and hip arthroplasty using a propensity score matching.BMJ open · 2021Article
- Bilateral total knee arthroplasty: Simultaneous versus staging in the same or in twice hospitalization.Journal of clinical orthopaedics and trauma · 2021Article
- One-stage versus 2-stage bilateral total joint arthroplasty: a matched cohort study.Canadian journal of surgery. Journal canadien de chirurgie · 2020Article
- When can I go home after my knee replacement? Factors affecting the duration of in-hospital stay after knee replacement.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2019Article
- Comparison of 90-Day Complication Rates and Cost Between Single and Multiple Joint Procedures for End-Stage Arthropathy in Patients with Hemophilia.JB & JS open access · 2018Article
- Simultaneous, same-anaesthetic bilateral total knee arthroplasty has low mortality and complication rates.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Article
- Comparative Outcomes Between the First and Second Operated Shoulders in Bilateral Shoulder Arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2018Article
- Investigation of perioperative safety and clinical results of one-stage bilateral total knee arthroplasty in selected low-risk patients.Journal of orthopaedic surgery and research · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn 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.
methodsAll 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.
resultsA 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 30 days (RR [relative risk] 3.67, 95% confidence interval [CI] 1.68-8.02, p = 0.001, I (2) = 59%, n = 67,691 patients), 3 months (RR 2.45, 95% CI 2.15-2.79, p < 0.00001, I (2) = 0%, n = 66,142 patients) and 1 year (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.
conclusionsThe results of the analysis suggest that simultaneous bilateral total knee arthroplasty has a significantly higher rate of mortality at 30 days, 3 months and 1 year after surgery, but similar infection and complication rates in comparison to staged bilateral total knee arthroplasty.
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Registered trials
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