Q: My arthritic knees need to be replaced. Is it a good idea to have them replaced at the same time?
A: The advantages of a bilateral knee replacement—when both knees are replaced at the same time—might seem obvious: You undergo surgery, a hospital stay, rehabilitation, and recovery just once, cutting down on cost, anesthesia risk, and time away from work and other activities.
However, a lack of high-quality clinical trials comparing the safety and outcomes of bilateral replacements directly with those of replacements done at different times makes it a debatable practice.
Most experts agree that bilateral knee replacement has its downsides. There’s a higher risk of complications, including increased bleeding, greater stress on the cardiovascular system, and higher risk of blood clots and infection. Some studies have shown an increased risk of death after bilateral knee replacement compared with staged surgeries.
You should also be aware that you may have to enter a rehabilitation facility after bilateral knee replacement, as you will be unable to stand and may not be able to function at home. And you’ll need close monitoring to avoid complications.
Generally, surgeons will consider bilateral knee replacement in people younger than 75 who are in excellent physical condition; are free from heart, lung, and vascular diseases; are not obese; and are prepared to tackle the unique challenges of recovery. Ask your surgeon for an assessment of your fitness as a candidate for bilateral knee replacement. Take some time to consider whether it’s something you want to pursue.
This article first appeared in the 2019 UC Berkeley Arthritis White Paper.
Also see Osteoarthritis: Causes and Treatments.