Can I Replace Both Knees at Once?

One of the most asked questions I get during appointments at Wyoming Orthopedics & Spine is if both knees can be replaced (operated on) at once.

My answer has always been the same: I don’t offer this kind of surgery because studies have shown significantly higher risks in operating on both knees at once than if doing one knee at a time.

My answer has understandably been frustrating for some patients, especially those working with a relatively short window to return to work or some other activity. However, I believe that one of my primary roles as an orthopedic surgeon is to prevent complications for my patients.

As typical with many areas in medicine, research in this area continues to evolve and some more recent studies have been published that show replacing both knees at the same time can be safe in SELECT patients. This group of select patients includes those who are under 70 years old without major medical problems like heart disease, diabetes, COPD, smoking or obesity. After age 70, or with one or more of the medical conditions listed, single total knee replacement can be done, but complication rates rise significantly if both knees are operated on at once. When two knee replacements are done, one after the other, they can be done as soon as eight weeks apart.

So what exactly do the studies show are the risks? The largest recent analyses used data from anywhere between 8,000 to 200,000 (or more) patients and shows that there continues to be a slightly higher risk (less than 1% increase overall) in blood clots, heart attack, lung problems and death. Fortunately these complications are very rare to begin with. There is also a longer initial recovery, higher blood loss and increase in initial postoperative pain. However, when patients who have other risk factors for these problems are selected out, the rates drop significantly.

On the other hand, when both knees are operated on at once, there is only one recovery and infection rate to deal with, only one need for a revision surgery, and readmission to the hospital are similar. Overall time off work, total rehabilitation time and cost are lower when doing both at one time.

While I certainly don’t believe that replacing both knees at once is the right choice for everyone, I do understand that in the right patient it can simplify the process.

I am always happy to discuss in person any questions regarding your particular situation to determine what would be best in your case.

Expert Orthopedic & Spine Care In Gillette, Wyoming

Dr. Stanford Israelsen is a board-certified orthopedic surgeon at Wyoming Orthopedics & Spine in Gillette, Wyoming. The physicians at WYOS take an innovative and comprehensive approach to the treatment of acute and chronic orthopedic pain. Have your procedure in our modern operating rooms at Campbell County Memorial Hospital or Powder River Surgery Center.

For a consultation, call 307.686.1413 or visit www.wyomingorthospine.com.