COMPLICATIONS AFTER CONCOMITANT BILATERAL TOTAL KNEE ARTHROPLASTY IN ELDERLY PATIENTS

Objective: To determine the risks associated with performance of bilat eral total knee arthroplasty (TKA) in elderly patients. Material and M ethods: Ninety-eight patients with osteoarthritis who were 80 years of age or older and underwent concomitant cemented bilateral TKA were ma tched (on the basis of gender, surgeon, year of surgical treatment, ag e, and diagnosis) with 98 patients who underwent cemented unilateral T KA to compare the number and types of complications in these two group s. The groups did not differ in the number and type or severity of pre morbid medical conditions, anesthetic risk, and type of anesthesia. Re sults: One hundred nineteen postoperative complications occurred in 63 patients in the bilateral TKA group; in contrast, 72 complications oc curred in 49 patients in the unilateral TKA group. The difference betw een the two groups in the total number of complications was significan t. Specifically, significant differences between the two groups were n oted in the occurrence of cardiovascular and neurologic complications. On paired analysis, congestive heart failure and acute delirium were found to be significantly more frequent in the bilateral TKA group tha n in the unilateral TKA group. We noted a trend toward an increased mo rtality rate in the bilateral group (four patients) versus the unilate ral group (no deaths). Conclusion: Patients 80 years of age or older w ho undergo concomitant bilateral TKA are at increased risk for cardiov ascular and neurologic complications during the postoperative period i n comparison with matched patients who undergo unilateral TKA.