What’s the Claim?
A well-matched, large-database study from a nationally representative all-payer source found that, compared to unilateral TKAs, patients undergoing same-day bilateral TKA had more than double the odds of:
- Pulmonary embolism
- Blood transfusion (the odds ratio for this almost-entirely preventable complication was nearly 8)
How’s It Stack Up?
Arthroplasty surgeons have been arguing about this one for a very long time, and, honestly, the persistence of this argument makes little sense to me. Most of the large, well-done studies (of which the current study is a great example) have convincingly pointed out the increased risks of same-day bilateral TKA. By contrast, the most-irresponsible claims favoring B TKA come from small, local studies that are too small to discern differences in uncommon — but nonetheless serious or life-threatening — complications. And systematic reviews of such soft stuff are nothing more than case studies in “garbage in, garbage out.”