The Power Of A Double Knee Replacement
Severe knee arthritis is the significant wear and tear of cartilage and bone in the knee. This condition leads to severe pain, stiffness, and limited mobility. Arthritis is not limited to a single joint and can occur in both knees simultaneously. A double knee replacement can offer a path to less pain, better movement, and an improved quality of life. This strategy requires proper planning and care. The patient must decide whether to replace both knees at once or adopt a staged approach. Each option has advantages and challenges and can lay the foundation for successful treatment.
What’s a knee replacement anyway?
A knee replacement is a surgical procedure that replaces damaged cartilage and bone with a prosthetic joint. Perhaps the most common joint replacement today, surgeons perform about 790,000 surgeries yearly. The procedure is ideal for severe arthritis, typical of advanced age. The cartilage and bone can no longer support the joint. Surgeons can perform a partial or total knee replacement. During surgery, the cartilage and bone are removed using surgical tools. A metal, plastic, or ceramic replacement tailored to the patient is then installed. After a recovery spanning 3-6 months, patients will enjoy more mobility and less pain.
Should you kill 2 birds with 1 stone?
Patients will have the option of replacing both knees in the same surgical procedure. The surgical team will prepare 2 implants and plan the surgery based on the makeup of each joint. The procedure will be longer and may require a larger team. Simultaneous surgery is an advantage as the patient has a single hospital stay and rehabilitation process. The initial recovery may be challenging, but the total time to a full recovery may be shorter. Rehabilitation for both knees at once can provide more stability and symmetrical results. Some patients believe this approach is more cost-effective and will take less time away from work or other activities.
What are the drawbacks of simultaneous surgery?
While there are many advantages, performing both surgeries at once has significant challenges. As both knees are healing simultaneously, patients will experience more postoperative pain and discomfort. This initial period can be mentally and physically unpleasant. There is a slightly higher risk of complications like blood clots since mobility will be severely limited. Some patients cannot choose an outpatient setting due to the risks, requiring a longer hospital stay. A simultaneous double knee replacement may not be ideal for older patients who do not have the strength or stamina for recovery. Consider these challenges before replacing both knees at once.
One at a time, please
A double knee replacement can be performed using a staged approach. The surgeons address the more painful knee first. After recovery, usually several months later, the patient can return to treat the other knee. A staged approach is less physically demanding on the body, with a lower risk of complications. With 1 knee still functional, patients can have some mobility after surgery. This advantage can be ideal for recovery, limiting blood clots, and supporting health and wellness. The completed surgery can provide surgeons with vital information before performing the next replacement. Surgeons typically recommend a staged approach for older patients with preexisting health conditions for safety reasons.
Are there any cons?
A staged approach expands the timeline for treatment. The patient now requires 2 hospital stays and 2 complete rehabilitation periods. The length of time can be stressful for patients and difficult to arrange time off from work or other activities. As a result, patients tend to delay the second surgery much longer than recommended. This may lead to an over reliance on the first knee replacement, impacting gait and reducing the durability of the knee implant. A staged approach can be more expensive, with 2 surgical costs and potential hospital stays. This option is more manageable from a pain perspective. However, a staged approach requires discipline, tenacity, and a strong support system.
Which should you choose?
Both options achieve the ultimate goal of replacing both knees, leading to an improved quality of life. However, choosing a staged or simultaneous approach can impact patient experience, cost, and long-term outcomes. Factors like age, physical health, and underlying health conditions play a critical role in the decision. If both knees are equally painful, replacing one at a time may not be helpful. If cost, time off work, and a support system are challenges, taking a staged approach over several months is best. A discussion with an experienced surgeon can help patients decide how to perform a double knee replacement as safely and efficiently as possible.
