Can Knee Replacement Surgery Be Done on Both Knees at Once?

Considering whether bilateral knee replacement surgery should be performed during a single procedure requires a careful evaluation of various factors including the patient's overall health, physical condition, and medical history. While some may find the thought of having both knees replaced simultaneously appealing for its speed and efficiency, the increased risks and challenges associated with this approach often make it a less favorable option for most patients.

Factors to Consider Before Bilateral Knee Replacement

The primary reason why many healthcare providers advise against performing both knee replacements at the same time is the significantly higher risk of morbidity and mortality. Given that bilateral knee replacement is considered an elective procedure, opting to do each knee one after the other generally ensures a safer outcome for the patient.

Patients who are physically and mentally fit, have good cardiovascular status, and are prepared for supervised rehabilitation are better candidates for this approach. For these individuals, having one knee replaced allows them to focus on the recovery process while monitoring their physical condition. This method can indeed shorten the recovery time, although it carries the risk that if one knee develops an infection, the other knee is likely to be affected as well. Due to these risks, bilateral knee replacement is generally not recommended for patients with diabetes, as they have a higher likelihood of developing infections.

Recovery and Rehabilitation

While some individuals, such as those in good physical condition or who are self-employed, might have a different perspective, the general consensus is that it is often more strenuous to recover from bilateral knee replacement than from a single knee replacement. Post-surgery, patients will need to undergo rehabilitation, as opposed to returning home immediately, due to the prolonged anesthesia and potential for greater blood loss.

A common recommendation is to identify the "worst knee" and prioritize its replacement. Rehabilitating this knee first can help prepare the body for the second knee replacement, which is typically performed one to six weeks later. Often, this staged approach results in a recovery time that is comparable to, if not shorter than, that of simultaneous bilateral knee replacements. Always discuss your specific situation with your surgeon to get tailored advice.

Real-life Examples

There are instances where patients have chosen to undergo bilateral knee replacement at the same time. For example, a friend who was self-employed opted to have both knees replaced on the same day in the hopes of quickly returning to work. This approach allowed him to start working again in just 10 days. However, after these replacements, he later underwent bilateral hip replacements, with both anterior replacements completed within a year and a similar recovery time.

In summary, while it is possible to have both knees replaced during a single surgery, there are several important factors to consider. These include physical condition, medical history, and the increased risk of complications. The challenges associated with bilateral knee replacements are significant, including greater blood loss, the need for multiple transfusions, and a more demanding rehabilitation process. Discuss your specific circumstances with your surgeon to determine the best course of action for your health and well-being.