To the Editor:

I read with interest the article by Memtsoudis et al.  1in the recent issue of Anesthesiology on perioperative outcomes after unilateral and bilateral total knee arthroplasty. When the authors discuss about the issue of benefits and risks of simultaneous versus  staged bilateral total knee arthroplasty, they have quoted an article by Sliva et al.  2 

In the original article by Sliva et al. ,2the authors have evaluated 332 patients who had bilateral knee replacement, of which 241 patients had staggered bilateral knee replacement with 4–7 days apart between the procedures during a single hospitalization. They found that patients who had sequential bilateral total knee replacement and staged bilateral knee replacement had 2.5 times more complications than the ones who had staggered bilateral knee replacement. The rates of complications for staggered bilateral knee replacement, sequential bilateral knee replacement, and staged bilateral knee replacement were 13, 35, and 31%, respectively. Major complications seemed to have occurred mostly in patients with staged bilateral knee arthroplasty. Hence, they had concluded that staggered bilateral total knee arthroplasty with procedures performed 4–7 days apart in a single hospitalization was a safe option.

In the article by Memtsoudis et al. ,1the aforementioned article by Sliva et al.  2has been quoted wrongly as “in a study including 267 patients who underwent bilateral total knee arthroplasty during the same hospitalization, Sliva et al.  found that bilateral procedures performed 4–7 days apart were associated with higher risk of mortality and morbidity when compared with simultaneously performed procedures.”

I am surprised by how the main conclusions in the original article2could be completely misquoted.1I hope in future, such inaccurate statements will be addressed right at the editing stage.

The Prince Charles Hospital, Brisbane, Australia. usha.nathan@gmail.com

References

1.
Memtsoudis SG, Ma Y, Gonzalez Della Valle A, Mazumdar M, Gaber-Baylis LK, MacKenzie CR, Sculco TP: Perioperative outcomes after unilateral and bilateral total knee arthroplasty. Anesthesiology 2009; 111:1206–16
2.
Sliva CD, Callaghan JJ, Goetz DD, Taylor SG: Staggered bilateral total knee arthroplasty performed four to seven days apart during a single hospitalization. J Bone Joint Surg Am 2005; 87:508–13