文献类型：期刊文献

英文题名：Comparing simultaneous and staged bilateral total knee arthroplasty: a systematic review and meta-analysis

作者：Wang, Hongzhao[1];Jiang, Yabing[1];Wang, Xiao[1];Zhao, Tianyun[1,2,3]

第一作者：王怀忠;王惠珍

通信作者：Zhao, TY[1];Zhao, TY[2];Zhao, TY[3]

机构：[1]Gansu Univ Chinese Med, Clin Coll 1, Lanzhou 730000, Peoples R China;[2]First Hosp Tianshui City, Dept Orthoped, Tianshui 741000, Peoples R China;[3]Tianshui 407 Hosp, Orthoped Med Ctr, Tianshui 741000, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Clin Coll 1, Lanzhou 730000, Peoples R China;[2]corresponding author), First Hosp Tianshui City, Dept Orthoped, Tianshui 741000, Peoples R China;[3]corresponding author), Tianshui 407 Hosp, Orthoped Med Ctr, Tianshui 741000, Peoples R China.|[10735]甘肃中医药大学;

年份：2026

卷号：21

期号：1

外文期刊名：JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH

收录：;Scopus(收录号：2-s2.0-105048723277);WOS:【SCI-EXPANDED(收录号:WOS:001862813200002)】；

语种：英文

外文关键词：Osteoarthritis; Total knee arthroplasty; Simultaneous; Staged; Meta-analysis

摘要：Objective For patients with bilateral knee osteoarthritis, staged bilateral total knee arthroplasty (StaBTKA) is generally considered lower in perioperative risk, while simultaneous bilateral total knee arthroplasty (SimBTKA) enables one-stage deformity correction and potential earlier rehabilitation, with its safety debated. This study aimed to systematically compare their clinical outcomes using available observational evidence. Methods PubMed, Embase, the Cochrane Library, Ovid, and Web of Science were systematically searched for studies published between January 1, 2000 and August 31, 2025. Cohort studies comparing SimBTKA and StaBTKA were included, and all eligible studies were observational in design. Results A total of 53 cohort studies involving 572,881 patients were included, comprising 244,207 patients in the SimBTKA group and 328,674 in the StaBTKA group. In studies reporting comparable short-term mortality windows, SimBTKA was associated with higher reported short-term mortality than StaBTKA (OR = 2.35, 95% CI 1.69-3.27, P < 0.001). SimBTKA was also associated with a higher incidence of deep vein thrombosis (OR = 1.45, 95% CI 1.37-1.53; P < 0.001) and greater transfusion requirements (OR = 4.42, 95% CI 3.11-6.28; P < 0.001). Length of stay tended to be shorter with SimBTKA, particularly in Asian studies; however, substantial heterogeneity limited the interpretability of a precise pooled estimate. In contrast, StaBTKA was associated with higher rates of superficial and deep infection (OR = 0.69, 95% CI 0.54-0.89; P = 0.004; OR = 0.65, 95% CI 0.61-0.70; P < 0.001). No significant differences were observed between the two strategies in revision rates, pulmonary embolism, neurological complications, or cardiac events. Conclusion SimBTKA and StaBTKA have distinct risk profiles rather than one being universally superior. SimBTKA was linked to higher reported short-term mortality, DVT, and transfusion, whereas StaBTKA was associated with higher infection rates. The mortality finding should be interpreted cautiously because survivor selection bias may underestimate true risk in the StaBTKA group. Surgical strategy should be individualized, balancing patient comorbidities, perioperative safety, treatment efficiency, and healthcare resource utilization.