• Arch Orthop Trauma Surg · Dec 2024

    Thrombotic events in patients underwent simultaneous bilateral total knee arthroplasty with modern perioperative blood management strategy.

    • Sachiyuki Tsukada, Masayoshi Saito, Hiroyuki Ogawa, Masahiro Nishino, and Naoyuki Hirasawa.
    • Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, 310-0035, Ibaraki, Japan. s8058@nms.ac.jp.
    • Arch Orthop Trauma Surg. 2024 Dec 2; 145 (1): 22.

    BackgroundThrombotic events, the leading cause of death after total knee arthroplasty (TKA), occurred more frequently in simultaneous bilateral TKA than unilateral TKA under conventional perioperative management. The aim of the study was to determine whether the simultaneous bilateral TKA using contemporary blood management strategies would be associated with higher risk of thrombotic events than unilateral TKA.MethodThis propensity score-matched cohort study included 1,069 patients, with 324 undergoing simultaneous bilateral TKA and 745 undergoing unilateral TKA. All TKAs were performed without use of a tourniquet and with use of intravenous tranexamic acid administration. For patients receiving chronic antithrombotic therapy, the antithrombotic medications were continued during the perioperative period, including on the day of the operation. The primary outcome was the thrombotic events up to 1 year after TKA.ResultsThe propensity score-matched cohort consisted of 324 matched pairs of patients. There was no significant difference between simultaneous bilateral and unilateral TKA groups in the occurrence of the thrombotic events (25 of 324 [7.7%] versus 19 of 324 [5.9%] patients, p = 0.44). Additionally, no significant differences were found in the occurrence of the bleeding events (1 of 324 [0.3%] versus 1 of 324 [0.3%] patients, p > 0.99) and death within the postoperative 1 year (1 of 324 [0.3%] versus 3 of 324 [0.9%] patients, p = 0.62).ConclusionThe rate of thrombotic events after simultaneous bilateral TKA with contemporary perioperative blood management strategies did not significantly differ from that after unilateral TKA.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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