Bilateral knee arthroplasty is the replacement of both knees during the same period of time. This procedure can be simultaneous, with both knees operated on during the same surgery, or staged, with separate surgeries performed on each knee a few days or weeks apart. Bilateral knee arthroplasty is performed on patients disabled by severe arthritis in both knees. While the bilateral procedure is longer and more complex than a single knee arthroplasty, the pain relief after surgery is much greater and the overall rehabilitation time is shorter.
There is some debate about whether the simultaneous procedure is preferable to the staged operations and also about whether bilateral arthroplasty is always more beneficial than two widely spaced operations.
Advantages of the Simultaneous Bilateral Procedure
There are several important advantages to a bilateral total knee arthroplasty, including:
- Single administration of anesthesia
- Shorter hospital stay
- Reduced costs
- More efficient correction of bilateral bone deformities
The great majority of patients who have had the bilateral procedure say that they were pleased with the results and, if given the choice, would choose this method again. Once the immediate postsurgical pain abates, they experience relief in both knees. In addition, they only have to undergo one surgery and one period of rehabilitation.
What Happens During My Consultation?
During your initial consultation for bilateral knee arthroplasty at Utah Orthopaedics, you will meet with one of our highly-skilled orthopedic surgeons who draw from years of experience in orthopedics, sports medicine, physical therapy, and more. Depending on your medical history, current health, and the goals needed to achieve the full, pain-free function of the knees, your consultation may consist of an orthopedic examination as well as a personal discussion about your knee replacement options. Patients may also undergo preparatory testing that can involve a medical evaluation, blood samples, X-rays, and urine samples. During your consultation, your surgeon will spend time getting to know more about you and your health to develop a personalized treatment plan.
How Do I Prepare for My Bilateral Knee Arthroplasty?
Preparing ahead of time for your bilateral knee arthroplasty can lead to a complication-free procedure and recovery. Before showing up to your appointment, we recommend patients commit to the following at least several weeks before their procedure:
- Consult with your primary doctor about temporarily stopping prescription medications that may interfere with the procedure.
- Avoid alcohol.
- Quit smoking at least six weeks before your procedure.
- Arrange transportation with a loved one to and from your procedure.
- Prepare your home for ease and mobility during your recovery period.
- Identify a loyal caretaker who can help support you during your recovery period.
Risks of Simultaneous Bilateral Procedure
While total knee arthroplasty is considered a safe operation, it carries the risks of any surgical procedure, including excessive bleeding, blood clots, infection and adverse reaction to medication or anesthesia. The rate of these complications is approximately the same for bilateral or singular operations. For some patients, early rehabilitation may be more difficult after the bilateral surgery since there is not an unaffected leg to use for support.
Bilateral total knee arthroplasty is not usually recommended for patients who are over 80 years of age or patients who have serious underlying medical conditions. In these situations, bilateral surgery may present a greater risk since it is a larger, more traumatic event than smaller, more widely spaced procedures. Patients in these categories are at greater risk of developing cardiopulmonary and neurological complications or of requiring blood transfusions.
What Is Recovery Like After the Procedure?
Recovery after a bilateral knee arthroplasty can be a challenge. However, with the right support, patients are able to find their way back to full health within a 13-week period. Following your surgeon and physical therapist’s instructions during recovery will play a huge role in how quickly and effectively you recover.
After your procedure, you may experience pain and swelling in the legs. This will make it difficult for you to stand or walk for up to six weeks. However, after this time, the pain will slowly subside, and you can begin to focus on walking without any assistive devices.
Though recovery and rehabilitation can be challenging, having a bilateral knee arthroplasty provides patients the option to recover all at once. Patients who only have one knee treated at a time double their recovery process. The bilateral knee arthroplasty allows patients to minimize their recovery time, eliminates the need for additional physical therapy, and gets them back to their total health faster.