Bilateral Total Knee Arthroplasty (TKA) in a One-Stage Procedure Versus Two-Stage Procedure: A Retrospective Study

<b>Background/Objectives:</b> This retrospective study aims to evaluate the safety and functional outcomes of simultaneous bilateral total knee arthroplasty (TKA) compared to two-stage bilateral TKA procedures. Osteoarthritis is the leading cause of knee joint replacement globally, so we sought to determine whether the one-stage approach could be deemed non-inferior to the two-stage method in terms of perioperative complications and postoperative recovery. <b>Methods:</b> We analyzed two cohorts: 43 patients underwent one-stage bilateral TKA, while 66 patients received two-stage TKA. The data collected included demographic details, comorbidities, postoperative complications, and functional outcomes assessed by the Oxford Knee Score (OKS), European Quality of Life, and Visual Analogue Scale scores at preoperative and five years postoperative follow-ups. <b>Results:</b> The results showed statistically significant improvements in quality-of-life measures for both groups, with the one-stage group exhibiting greater enhancement in OKS (<i>p</i> < 0.05). Complication rates were similar across both procedures, with no significant differences in infection rates or other adverse events. <b>Conclusions:</b> This study suggests that the one-stage approach to treat bilateral knee arthritis could reduce subjective stress and healthcare costs, presenting a safe alternative for appropriately selected patients. However, the findings highlight the necessity of considering patients' overall health status when planning surgical interventions. Further research involving larger populations is recommended to validate our conclusions.