Can obese patients undergo simultaneous bilateral total knee arthroplasty without an increased risk of perioperative complications?

Simultaneous bilateral total knee arthroplasty (simBTKA) remains controversial, especially in obese patients. Therefore, this retrospective study compared six month perioperative complications in 313 simBTKA patients. Comparison groups included 139 non-obese patients (BMI < 30), 61 obese patients (BMI = 30-35) and 48 severely obese patients (BMI > 35). Increased BMI was associated with longer tourniquet and surgical times (p < 0.001). However, no differences were found for transfusion (p = 0.288), deep infection (p = 0.971), pulmonary embolism (p = 0.454), or deep vein thrombosis (p = 0.670). Increased BMI was, therefore, not associated with greater post-operative complications and should not necessarily contraindicate simBTKA.