Bilateral knee replacement is a single procedure or a double procedure where both of the knee joints are replaced by metal and plastic implants
Overview of the procedure:If both knees are replaced the same day in the same procedure it is called a simultaneous procedure. This procedure typically takes 3-4 hours. If one knee is replaced and rehabbed before the second knee is replaced (approximately 3 months later) it is called a staged procedure. This procedure takes approximately 2 hours. Please see: total knee replacement (link) to read more about the details of this procedure
Pre-Treatment considerations
Whether the bilateral knee replacement is done as a single procedure or a double procedure, it is performed on patients with severe arthritis causing pain/stiffness in both knees and significantly interfering with activities of daily living, thus reducing quality of life. The patient must not be severely overweight or obese for a bilateral knee replacement to be performed. Patient and physician together will make the decision of whether a simultaneous procedure or a staged procedure will be performed. For a simultaneous procedure, the patient must not have any heart or lung problems. Patients for a bilateral knee replacement are typically 60 years old and older.
Post-Treatment considerations and recovery
- 3-5 day hospital stay for a staged procedure and up to a 10 day hospital stay for a simultaneous procedure
- Early movement is critical
- Pain medication and non-steroidal anti-inflammatory drugs will be prescribed
- Within 6 weeks formal physical therapy is begun on either the one leg (staged) or both legs (simultaneous)
- There will be 6-12 weeks of formal physical therapy
- If a staged procedure is chosen, the second procedure will be done approximately 3 months after the first procedure.
- Full recovery takes approximately 12 months
Pros and benefits
- Pros for a simultaneous procedure: one single surgery, one anesthesia bout, less expensive since there is only one procedure performed, able to rehabilitate both knees at the same time.
- Pros for a staged procedure: less stress on heart and lungs, better for the elderly, the overweight, and those with severe medical issues, faster procedure and less recovery time since only one knee is being repaired at a time.
Cons, risks, and possible side effects
- Cons for a simultaneous procedure: longer hospitalization, longer procedure and therefore being under anesthesia longer, more blood loss, more intense physical therapy, may have to go to a rehabilitation facility before being able to go home, totally non-weight bearing at first meaning the patient will have to be in a wheel chair
- Cons for a staged procedure: two hospital stays instead of one, two times going under anesthesia, longer total recovery time
- Cons, risks, and possible side effects for either procedure of bilateral knee replacement: infection, blood clots, heart attack, stroke, nerve damage, blood vessel damage, failure of prosthesis.
- Men are more at risk for complications than women.
- Those older are more at risk of complications
