Putnis SE, Klasan A, Redgment JD, et al. - Given the far greater mortality and risks of bilateral total knee arthroplasty (BTKA) vs unilateral total knee arthroplasty (UTKA), researchers examined whether the use of contemporary anesthetic and surgical techniques for one-stage single anesthetic sequential BTKA affect this observation. They formed two cohorts of 394 patients by propensity matching for gender, age, body mass index, American Society of Anesthesiologists grade, and Veterans Rand-12 health survey scores. Outcomes revealed that in the majority of patients, BTKA was safe and effective. After both UTKA and BTKA, far lower transfusion rates were reported in this work compared with historically reports with the rare occurrence of major complications. They noted a significant increase in the rate of pulmonary embolism after BTKA, particularly in high-risk patients. The cohorts exhibited the same significant clinical improvement and high level of satisfaction at a minimum 1-year postoperative follow up.