A paper presented at the 25th annual meeting of the American Association of Hip and Knee Surgeons in November 2015, reviewed the complications following bilateral simultaneous total knee replacement versus bilateral staged, i.e., separate dates total knee replacement. Dr. Sheth and colleagues reviewed over 11,000 patients from an integrated health system joint registry program. They found overall death rates and complications for both the simultaneous and staged group were quite rare. They concluded there is no increased risk of revision, infection or death or complications in bilateral simultaneous versus staged total knee replacement. This agrees with our indications for patients with bilateral simultaneous total knee replacement which includes patient’s under the age of 70, normal weight, without a history of cardiac or pulmonary problems. In appropriately selected individuals, the overall total recovery can be shortened by doing both knees at once, but patients need to be in excellent health and appropriate weight to accomplish this safely.