What is a Simultaneous Bilateral Total Knee Replacement?
A simultaneous procedure means that both knees are replaced on the same day, under one anesthesia. This takes place as a single surgery, within one hospital stay and is followed by a single rehabilitation period.
What is a Staged or sequential double Knee Replacement?
The staged procedure means that the knee replacements are performed as two separate surgical events. Surgeries are typically performed several months apart one from the other, requiring two hospital stays, two anesthesias and two rehabilitation periods. They can also be done sequentially with a gap of four or five days between the two surgeries.
Who should have a Bilateral Total Knee Replacement?
The most common reason for a Bilateral Total Knee Replacement is severe arthritic pain equally symptomatic in both knees, that interferes with the patient's activities of daily living and significant reduces the patient's quality of life. Usually complaints are worst with weight bearing activities, as standing and walking. Untreated, knee arthritis is usually painful, functionally limiting, as it progressively compromises the patient's independence over time.
What are the advantages of a Simultaneous Total Knee Replacement?
The advantages of having a simultaneous procedure include: only one surgical event, a single anesthesia, a shorter overall hospital stay, and the possibility of rehabilitating the patient symmetrically.
What are the risks with simultaneous replacements
Although there are no prospective studies, there are risks. The biggest is mortality, followed by morbidities like a cardiac event.
Although there is no specific age limit laid down, cardiac risks, elderly age, may increase the risk.
I use a cut off age of 60 years for bilateral knees.
What are the advantages of a Staged Total Knee Replacement?
The advantages of having a staged procedure include apparently lower stress level for the cardiovascular system, fewer complications related to the heart, a lower incidence of blood clots within the deep veins, as well as lower possibility of requiring banked blood after surgery. This is an excellent choice for patients with cardiac, vascular or pulmonary diseases or above 80 years old.
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