ArticleEFORT open reviews2025
Optimal timing for bilateral total knee arthroplasty: comparing simultaneous and staged procedures at various intervals: a systematic review and network meta-analysis.
Article in EFORT open reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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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.
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Who cites it
4 citing papers in PubMed.
- Unicompartmental and total knee arthroplasty in the same patient for the treatment of bilateral knee osteoarthritis: a systematic review of literature.EFORT open reviews · 2026Article
- Second-Knee C-Reactive Protein After 1-Week Staged Bilateral Total Knee Arthroplasty.Orthopaedic surgery · 2026Article
- Second-knee transfusion burden persists under a high-dose intravenous iron protocol without tranexamic acid in one-week staged bilateral total knee arthroplasty: a paired cohort study.BMC musculoskeletal disorders · 2026Article
- The impact of conversion arthroplasty for failed femoral neck or intertrochanteric fractures on complication and mortality rates: A "second-hit" effect?Journal of the Chinese Medical Association : JCMA · 2026Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: A staged bilateral total knee arthroplasty (BTKA) procedure is considered when a patient is not deemed suitable for simultaneous BTKA due to concerns about the risk of mortality and complications. However, no network meta-analysis has been conducted to compare simultaneous vs staged BTKA procedures with different intervals in terms of postoperative mortality and overall complication rates. Methods: Four databases - Medline, Embase, Cochrane Library and Web of Science - were searched from inception to December 19, 2023, for studies comparing patients who underwent staged BTKA with different intervals and simultaneous BTKA. The primary outcome domains were 1-year mortality and 90-day overall complications. Secondary outcomes included neurological, cardiovascular, pulmonary, infectious and venous thromboembolic complications within 90 days. Results: Fifteen observational studies were included. Staged BTKA with intervals between 6 weeks and 3 months (odds ratio (OR): 0.69, 95% CI: 0.53-0.91), between 3 and 6 months (OR: 0.67, 95% CI: 0.53-0.84) and longer than 6 months (OR: 0.67, 95% CI: 0.55-0.83) exhibited a lower mortality risk compared to simultaneous BTKA. Staged BTKA with an interval shorter than 6 weeks and longer than 6 months exhibited a higher risk of pulmonary (OR: 1.24, 95% CI: 1.03-1.49; OR: 1.64, 95% CI: 1.10-2.44) and infectious complications (OR: 1.50, 95% CI: 1.15-1.96; OR: 1.52, 95% CI: 1.14-2.02) compared to simultaneous BTKA. An interval between 3 and 6 months ranked best in outcomes of 1-year mortality (P score = 0.7849) and 90-day complications (P score = 0.7077). Conclusions: Staged BKTA with an interval of more than 6 weeks but less than 6 months is associated with a lower risk of postoperative mortality and complications. However, these results should be interpreted with caution due to potential biases inherent in the inclusion of nonrandomized studies. Level of Evidence: II.
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