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All you need to know before considering replacement surgeries for both knees simultaneously

You may require a total knee joint replacement due to various medical reasons. An unfortunate accident which severely damages your knee or having debilitating arthritis are the most common reasons where people have to get their knee or both knees replaced.

Arthritis is a condition of inflamed joints and affects 15% of the Indian population. A damaged, worn off cartilage in one or both knees is a characteristic symptom of this disease. Total knee arthroplasty is an effective treatment option for arthritis and replaces your damaged joint and relieves pain.

Your doctor will substitute your knee joint with a prosthesis which is an artificial knee made up of either metal, plastic, or ceramic.   

How does double knee replacement surgery work?

In cases where both the knees are severely damaged and affect your daily activities, your doctor may recommend a double knee replacement surgery. 

It is of two types:

  • Staged Bilateral Knee Replacement: In this, both your knees are replaced one by one, in two separate surgeries, keeping a gap of a few months in between.
  • Simultaneous Bilateral Knee Replacement: In this, both the knees are replaced during the same surgery

Your doctor will determine the procedure that works best for you after considering your underlying medical conditions carefully.

Can both knees be replaced at the same time?

A single surgery for both the knees simultaneously puts a lot of stress and strain on your body. Should you have both knees replaced at the same time is a common question that concerns people. Not everyone can handle the pressure and other complications of this type of surgery.

However, your doctor may consider you a suitable candidate for the procedure if:

  • You are young, active and have good muscle strength.
  • You are otherwise physically fit and have good overall health.
  • You do not have underlying medical issues relating to your heart and lungs.

Pros and cons of having both knees replaced at the same time?

It is essential to be aware of all pros and cons associated with simultaneous bilateral knee replacement surgery before considering it.

Though it finishes-off the work in one go, this type of surgery has its share of benefits and risks. You have to approach it cautiously and go ahead only after a thorough discussion with your doctor.

Pros

  • More convenient as replacement surgery for both the knees takes place in a single procedure.
  • You may need less time off from work. You don’t have to repeat office leaves for two surgeries as in the case of staged bilateral surgery.
  • The time for recovery after knee replacement surgery is single for both the knees. It means you don’t have to wait to get one knee operated and healed and then wait again after the second one.
  • You may also enjoy the benefits of reduced cost with a single surgery. Your cost savings can be anywhere between 18% to 26%.

Cons

  • Bilateral total knee arthroplasty requires prolonged anaesthesia which carries additional risk for patients with underlying heart or lung issues.
  • It involves more blood loss than single knee replacement procedures. You may require a blood transfusion to avoid further complications.
  • There’s an increased risk of forming blood clots post-surgery.
  • In a simultaneous bilateral total knee replacement complications are higher (3.8% in simultaneous bilateral knee replacement and 2.2% in single knee replacement).
  • You require more assistance during your recovery period as both knees are recovering and there’s no leg for partial support.
  • It is not suitable for all. Those with high-risk medical conditions are strictly not recommended to go for this type of surgery.

How much time will it take to recover in total knee replacement surgery?

When you undergo replacement surgery for both the knees at the same time, you may require to stay in the hospital for up to ten days. After that, you are shifted to a rehabilitation centre for physical therapy to help you recover better. You may require physical assistance for up to three weeks after this surgery.

In a staged bilateral knee replacement, the doctor may keep you in the hospital for three to five days after each surgery. You may need a helper for the first week and after that an assistance device like cane, walker, crutches, till you can manage on your own.

The total knee replacement recovery time can take anywhere between six to twelve weeks.

Though the recovery after knee replacement surgery is the same in both types of double knee replacements, you can get back to your daily life faster in the simultaneous bilateral procedure.

The staged knee replacement usually happens for a total period of six months to one year. The doctor operates on one knee and gives it time to heal and then keeping a few months gap, the other knee is operated upon and given time to recover.

It is important to note that your full knee replacement recovery will also depend on your age and overall health.

What to expect after total knee Arthroplasty

There is a significant reduction in knee-pain right after the surgery. However, surgery-related pain is mild and temporary and easily managed by pain-killers. Your doctor will check for any signs of infection, blood clots or any other complication that may arise post-surgery, during your hospitalisation. 

Physical therapy will start soon after the surgery to help you with some movement. These sessions aim at building strength and regaining mobility. The therapist will include some knee-strengthening exercises and make you walk gradually. How long you will require physical therapy will depend on your health and progress.

Read: Quality of life after Total Knee Replacement Surgery

In closing

Despite the challenges present in double knee replacement surgery, be it a staged procedure or simultaneous knee replacement, it is often successful in repairing your knees completely.

Nonetheless, getting both knees replaced at the same time is a big decision to take for anyone. Just being aware of the benefits and risk factors of each type of knee replacement surgery isn’t enough. Nothing can replace the experience of visiting a doctor personally and talking about your condition and preferences.

Your doctor is the best person who will diagnose the severity of your knees and recommend a suitable treatment option. 

Read: The risk of delaying Knee Replacement Surgery

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Author: Dr Debashish Chanda
An experienced Orthopedic surgeon, Dr. Debashish Chanda specialised in robotic knee and hip surgeries from Germany. He brings with him over 14 years of experience in treating a wide range of orthopedic ailments with a focus on knee surgery.
 
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