Many people are faced with the situation of having significant pain from arthritis in both of their knees. When conservative measures such as modification of activity, oral anti-inflammatory medications, and injections have failed, a decision about the timing and/or staging of knee replacement is faced.
In healthy individuals who do not have risk factors and are not obese, bilateral knee replacements at one anesthetic is a reasonable option to entertain. There have been several studies comparing unilateral with bilateral knee replacements with regard to results and complications. The majority of studies support the performance of bilateral knee replacements at one anesthetic in the younger healthier individual. Patients over the age of 70, patients with a history of cardiac or pulmonary problems, the obese individual, and the person with poor pain tolerance are not as good a candidate for a simultaneous bilateral knee replacement. A recent study supported the use of bilateral knee replacements and found that they were more common with high-volume surgeons and high-volume hospitals that can handle some of the unique challenges that bilateral knee replacement presents.
If you have significant arthritis in both of your knees and nonoperative measures have failed to alleviate the symptoms, then you should discuss the possibility of bilateral knee replacement with your orthopedic surgeon.
William P. Barrett, M.D.