If you need both your knee joints replaced, can you have the two procedures at the same time? Alex Dodds, knee specialist for Gloucestershire, explains.
A replacement on both knees simultaneously is known as a bilateral knee replacement. They do happen. On my Australian fellowship I performed several, always on patients who were fit and well and for whom surgery presented little medical risk.
The bilateral replacement was usually performed for partial rather than total knee replacements and involved two surgeons operating simultaneously, taking one knee each.
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Bilateral knee replacement: benefits and risks
There are advantages to performing a bilateral procedure, most notably the fact that two knee replacements are carried out in around an hour, reducing the number of occasions a patient needs to be anaesthetised and removing the need for two trips to hospital, two sets of recovery and, if you’re still in work, two periods of absence.
But there are issues. A bilateral procedure does increase surgical risk somewhat. The risk of blood loss is greater and the need for transfusion more common. Recovery from having both knees treated at the same time takes a little longer as there’s no ‘good’ knee to support the recovering one, although there’s only one period of recovery. You’ll spend longer under sedation too, which is another risk factor.
That’s not to say that bilateral knee replacements never happen in the UK, but for patients who need both knees replacing, it’s far more common for the operations to take place sequentially, which reduces blood loss, anaesthetic time and overall risk.
Generally speaking, we like to leave around three months between procedures to give patients time to recover from one operation before they face the second.
Offloading the knee
Sometimes, a patient will appear to need both knees replacing but one will take priority. Having had the most urgent joint replaced, it may be that the second feels considerably better than it did, or that we can offload the second knee (for example, by using a brace) so that the need for surgery is removed or, at the very least, delayed.
If you’re suffering from osteoarthritis in the knees, let’s talk about options for your knee surgery. Book your appointment at my knee clinic now or call 01242 246549.
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