{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:02:09Z","timestamp":1789844529544,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":83,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Staged bilateral total knee arthroplasty (BTKA) is increasingly performed, yet the influence of inter\u2010stage timing on complications and patient\u2010reported outcomes (PROs) remains unclear. This study evaluated whether timing between staged BTKA procedures was independently associated with 90\u2010day complications or failure to achieve the minimal clinically important difference (MCID) in 1\u2010year PROs after the second surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective study of 2410 patients who underwent staged BTKA at a high\u2010volume single institution (2014\u20132024). Timing was assessed using quartiles, a \u22646 versus &gt;6\u2010week cutoff, and as a continuous variable. The primary outcome was any 90\u2010day complication after the second procedure, as defined by The Knee Society Guidelines. Secondary outcomes included failure to achieve MCID at 1\u2010year for the knee injury and osteoarthritis outcome score for joint replacement (KOOS\u2010JR) and veterans RAND 12\u2010item survey (VRS\u201012) physical (PCS) and mental component scores (MCS). Multivariable regression adjusted for demographics, second\u2010stage preoperative PROs, and complications after the first stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median time between stages was 245 days. Timing was not independently associated with 90\u2010day complications or failure to achieve MCID at 1\u2010year in adjusted models. Prior complications after the first procedure (odds ratio [OR]: 4.01, 95% confidence interval [CI]: 2.21\u20137.26;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and ASA III\u2013IV (OR: 1.60, 95% CI: 1.05\u20132.43;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028) were associated with increased complication risk. Failure to achieve MCID after the first surgery was strongly associated with subsequent MCID failure following the second surgery (KOOS\u2010JR: OR: 26.34; VRS\u201012 PCS: OR: 31.67; MCS: OR: 8.69; all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Inter\u2010stage timing was not independently associated with complications or failure to achieve MCID at 1\u2010year after adjustment for patient\u2010level factors. Prior surgical response and ASA classification demonstrated stronger associations with postoperative outcomes following the second stage than timing alone. These findings support individualised surgical planning and shared decision\u2010making rather than reliance on fixed interval thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70809","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:19:26Z","timestamp":1782213566000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of interstage timing and prior surgical response with outcomes following staged bilateral total knee arthroplasty: A retrospective cohort study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9456-6045","authenticated-orcid":false,"given":"Jake M.","family":"Laverdiere","sequence":"first","affiliation":[{"name":"Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"},{"name":"Frank H. Netter, School of Medicine, North Haven Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekrem M.","family":"Ayhan","sequence":"additional","affiliation":[{"name":"Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"},{"name":"Frank H. Netter, School of Medicine, North Haven Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas P.","family":"Giannasca","sequence":"additional","affiliation":[{"name":"Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"},{"name":"Frank H. Netter, School of Medicine, North Haven Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan A.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Connecticut Health Center Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baseel M.","family":"Hamideh","sequence":"additional","affiliation":[{"name":"Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"},{"name":"Frank H. Netter, School of Medicine, North Haven Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martinus","family":"Megalla","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery University of Connecticut Health Center Farmington Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Grosso","sequence":"additional","affiliation":[{"name":"Connecticut Joint Replacement Institute at Saint Francis Hospital Hartford Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.12.037"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1749-799X-5-84"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.05.019"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.07.083"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002857"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.88B8.17862"},{"issue":"6","key":"e_1_2_12_8_1","first-page":"633","article-title":"Staged bilateral total knee arthroplasty: when should the second knee be replaced?","volume":"9","author":"Ghasemi SA","year":"2021","journal-title":"Arch Bone Jt Surg"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.19.00243"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-012-2489-y"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.01681"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11420-012-9315-7"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.03.010"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000192040.40523.df"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-024-02442-y"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2002.30286"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004479-200401000-00012"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12640"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.17.00948"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2025.06.080"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.04.033"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-025-02915-8"},{"issue":"6","key":"e_1_2_12_23_1","first-page":"497","article-title":"Risks and benefits of elective hip replacement in the octogenarian","volume":"137","author":"Phillips TW","year":"1987","journal-title":"Can Med Assoc J"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.03.087"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2019.06.008"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.87B6.15121"},{"issue":"6","key":"e_1_2_12_27_1","first-page":"641","article-title":"Clinical outcome comparison between staged\u2010bilateral versus simultaneous bilateral total knee replacements","volume":"9","author":"Sarzaeem MM","year":"2021","journal-title":"Arch Bone Jt Surg"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2014.12.014"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.01.037"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.OA.22.00112"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2021.01.007"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2022.08.039"},{"issue":"1","key":"e_1_2_12_33_1","article-title":"ASA class predicts early revision risk","volume":"10","author":"Wall CJ","year":"2025","journal-title":"JBJS Open Access"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.22.00194"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-06135-w"}],"container-title":["Journal of Experimental Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70809","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jeo2.70809","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jeo2.70809","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:15:22Z","timestamp":1789841722000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1002\/jeo2.70809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/jeo2.70809"],"URL":"https:\/\/doi.org\/10.1002\/jeo2.70809","archive":["Portico"],"relation":{},"ISSN":["2197-1153","2197-1153"],"issn-type":[{"value":"2197-1153","type":"print"},{"value":"2197-1153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-05-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70809"}}