Bilateral Knee Replacement

What is a "Simultaneous" Bilateral Total Knee Replacement (BTKR)?

In a simultaneous procedure both knees are replaced in one operation, on the same day under one anesthesia.  This means that there is one hospitalization and one recovery period.   Certain patients are at higher risk for medical complications if they undergo simultaneous bilateral knee replacement surgery. Your physician will discuss with you the relative merits and safety of simultaneous BTKR.

What is a "Staged" Bilateral Total Knee Replacement?

The staged procedure means that both knee replacements take place as two separate surgical events. Surgeries are planned to be performed several months apart one from the other, requiring two hospital stays, two episodes of anesthesia and two rehabilitation periods. The time between surgeries may vary depending upon your individual medical condition but most surgeons will want you to recover about 3 months from the firstsurgery before you undergo the second surgery.

Why would I need to get a BTKR?

The most common reason for a Bilateral Total Knee Replacement is severe arthritis that is causing pain and stiffness in both knees interfering with activities of daily living and significantly reducing one’s quality of life. Stiffness can be significant making simple tasks such as putting on your shoes and socks very difficult.  Pain is usually worsened with weight bearing activities, such as standing and walking. Arthritis of the knee is a progressive condition that usually worsens with time.

The ideal candidate for a simultaneous total knee replacement would be a younger, healthier, non-obese individual with stiffness, pain, and limitation of activities that significantly reduces one’s quality of life.

Another reason to consider a simultaneous procedure is for those patients who have significant deformity of both knees.  Correcting the deformity of both knees at the same time will allow the patient to walk straighter and facilitate rehabilitation.


What are the advantages of a Simultaneous Total Knee Replacement?

The advantages of having a simultaneous knee replacement in the properly selected patient include: only one surgical event, one episode of anesthesia, shorter overallhospital stay and the ability to rehabilitate both new knee replacements at the same time.

What are the advantages of a Staged Total Knee Replacement?

The advantages of having a Staged procedure includes lower stress level for the cardiovascular system (heart and lungs) as well as a lower risk of requiring blood transfusion after surgery. In general, elderly and/or obese patients and those with serious medical issues are best treated with a staged procedure. Your surgeon will help you decide what the best choice is for you.

Who would not be a candidate for Simultaneous Bilateral Total Knee Replacement?

This procedure is not encouraged in older or obese patients with substantial health conditions, such as heart, lung, and/or vascular disorders.  These patients would be at increased risk for significant perioperative complications.

Potential Complications

What are the disadvantages of a simultaneous bilateral knee replacement?

The simultaneous procedure may require a longer hospitalization and a more intense period of rehabilitation.  While most patients who receive simultaneous BTKR can go home after surgery, some patients may have to go to a rehabilitation facility.

What are the disadvantages of a Staged BTKR?

The disadvantages of having a Staged procedure is that it requires two hospital stays, two episodes of anesthesia and delays full return to work from disability as compared to simultaneous knee replacement.


What are the results in terms of function and relief of pain?

The ultimate success of the operation should be the same in both the simultaneous and staged procedures. Your surgeon is the best source to help you decide what’s best for you.

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