Should I have Bilateral Simultaneous Knee Replacement?
Many patients suffer from bilateral knee osteoarthritis and want to consider having the surgery in one go, rather than as two separate procedures. As with most things there are pros and cons to this question.
The patient who may be considered suitable for bilateral simultaneous surgery is that person who has severe pain and or dysfuntion affecting both knees equally. Usually if one knee is very sore and the other is not too bad, then one knee at a time is recommended. Often after the first knee replacement is performed, the other knee settles a little, giving sometimes years before surgery needs to be considered on the other side.
On the other hand occasionally the pain and disability associated with both knees is severe and bilateral surgery is considered.
The benefit of bilateral simultaneous surgery is that the two knee operations are compressed into one procedure, which shortens the combined rehabilitation phase and costs of two separate procedures. This is particularly helpful if two periods of rehabilitation cause work or sick leave issues. Some authors note that the potential complication rate after simultaneous bilateral surgery is lower than staged bilateral surgery.
The disadvantages of bilateral simultaneous knee replacement surgery include a longer operating time, higher blood loss, higher likelihood of blood transfusion and a higher risk of cardiovascular complications.
In general I will consider patients for bilateral simultaneous knee replacement if they fulfil the following criteria.
- Aged <80
- No systemic cardiovascular disease
- No Diabetes
- No Kidney disease
- Severe bilateral disabling knee pain
Each individual patient will have their own circumstances and health to consider. Usually a thorough preoperative medical review will determine suitability for the procedure. You should discuss with your surgeon your suitability if you have severe bilateral knee osteoarthritis and are considering knee replacement.