Comparison of complications following simultaneous versus unilateral total knee arthroplasty

Total knee arthroplasty (TKA) was introduced into Mongolia during the mid-2000s. The first bilateral total knee arthroplasty (BTKA) was performed at Joint Center of the First Central Hospital of Mongolia (FCHM) in 2008. From 2011, the number of patients who undergone TKA has been increasing progressively due to TKA’s efficiency, as well as social welfare compensation and insurance coverage. In the years after its introduction, TKA has been performed frequently because it has been shown that it is a clinically efficient procedure for relieving pain and restoring functions for the cases with end-stage joint diseases such as osteoarthritis and rheumatoid arthritis. At the same time, the patients’ choice to undergo TKA also depends on their ability to pay their portion of its costs. Nevertheless, without standardized criteria it is challenging for doctors to decide who are appropriate patients for BTKA. In Mongolia, joint replacement surgeons are more concerned about age, body mass index (BMI), patient’s desires rather than the length of stay in hospital, or the cost of treatment when selecting patients for BTKA. It has been reported that there is a higher risk of perioperative and postoperative complications following BTKA compared to unilateral TKA (UTKA). Although a patient with symptomatic bilateral knee arthritis can be treated by replacing both knees during a single operative session, the rates of perioperative and postoperative morbidity and mortality remain a major concern.The purpose of this study is to conduct a systematic review of our experience following UTKA and BTKA.