Comparative Analysis of the Clinical Outcomes, Complications and Patient Satisfaction of One-stage versus Two-stage Bilateral Total Knee Arthroplasty

BACKGROUND: The safety of single-stage bilateral total knee arthroplasty (TKA) has been a subject of debate due to concerns of morbidity and mortality. The advantages of one-stage (OS) bilateral TKA include shorter recovery time, a shorter hospital stay and perhaps reduced total treatment costs. AIMS: This study aimed to evaluate the clinical outcomes and complications following OS versus two-stage (TS) bilateral TKA for severe osteoarthritis of both the knees. PATIENTS AND METHODS: This retrospective comparative analysis was carried out between January 2021 and December 2025 at the National Orthopaedic Hospital, Dala, Kano, and the University of Abuja Teaching Hospital, Gwagwalada. Clinical outcomes using the KSS scoring system and the rate of complications were recorded. Patients' satisfaction was also documented using the Likert scale. The statistical analysis was performed using SPSS version 26.0. Using a level of significance of 0.5, the two independent groups were compared using independent Student's t -test. RESULTS: There was no significant difference in post-operative KSS between the two groups ( P = 0.717). The mean post-operative KSS in the OS and TS groups were 97.78 ± 1.78 and 97.76 ± 1.74, respectively. Post-operative complications also did not significantly differ in the two groups ( P = 0.712). CONCLUSION: In properly selected cases, OS bilateral TKA is less expensive and yields clinical outcomes, complication rate and patient satisfaction comparable to those of a TS procedure.