Simultaneous bilateral total knee replacement versus unilateral replacement.

Over a 5-year period the two authors performed 213 simultaneous (sequentially) bilateral total knee arthroplasties (426 knees). A matched series of 107 unilateral arthroplasties was performed within this time frame, and the two groups of patients were evaluated based on postoperative complications and functional improvements. The patients in both groups were primarily osteoarthritics with an average age of 70 years. Knee function according to Hospital for Special Surgery (HSS) scores showed no significant difference, with the postoperative scores for the bilaterals and unilaterals averaging 93.6 and 93.4, respectively. The complication rate in the bilateral series was not increased over the unilaterals; it was less. These results lead to the conclusion that in patients with bilateral arthritis, both knees should be operated on under a single anesthetic, providing the surgical team is able to carry out the operative procedure expeditiously.