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than PKP alone in improving BMD and bone marker levels, relieving pain, as well as reducing the risk of new fractures. More large-scale RCTs are needed to verify our findings. The aim of this study was to validate the age-adjusted Charlson comorbidity index as a clinical practice guideline for patient selection between unilateral total knee arthroplasty (UTKA) and bilateral simultaneous total knee arthroplasty (BSTKA). A consecutive series of 1016 patients undergoing UTKA (402 patients) or BSTKA (614 patients) was analysed. The age-adj
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