Bilateral Total Knee Replacement (BTKR)

What is Bilateral Total Knee Replacement?

Bilateral Total Knee Replacement is a surgery where artificial knee joint parts (prosthesis) are implanted in both your knee joints.

What is Simultaneous vs. Staged Bilateral Total Knee Replacement?

Bilateral Total Knee Replacement can be Simultaneous or Staged. Simultaneous Bilateral Total Knee Replacement is an operation in which diseased and damaged parts in both your knee joints are replaced by prosthesis during the same surgery. In Simultaneous Bilateral Total Knee Replacement surgery the recovery time may be slightly longer. In Staged Bilateral Total Knee Replacement, the operation for each knee is performed separately several months apart which requires you to be hospitalized twice, undergo anesthesia twice and also have two recovery and rehabilitation periods after Staged Bilateral Total Knee Replacement surgery.

Who are the ideal candidates for Bilateral Total Knee Replacement?

If you have severe pain and functional limitation in both your knees due to arthritic damage, if this pain interferes and limits your weight bearing daily activities like walking, standing, if you have several deformities in your knees resulting from arthritis, if you are younger than 80 years of age and if you do not have any heart, lung or vascular disease. then you are an ideal candidate for Bilateral Total Knee Replacement surgery.

Who is not an ideal candidate for Bilateral Total Knee Replacement?

If you have an active knee infection or a severe neurological problem of your leg, if you are above 80 years of age, if you have a concomitant heart, lung or vascular disease then Bilateral Total Knee Replacement surgery is not for you.

What is the outcome of Bilateral Total Knee Replacement?

In both types of operations i.e. Simultaneous or Staged Bilateral Total Knee Replacement, there is a 95% success rate for up to 15 years. The results are excellent and equivalent in terms of pain relief and return of function.

B . R . A . N . D . of Bilateral Total Knee Replacement

Benefits of Bilateral Total Knee Replacement

• Following Bilateral Total Knee Replacement surgery, there are relatively fewer cardiovascular complications and fewer incidences of deep vein thrombosis of the leg veins
• The general risks to the heart, lung and brain due to anesthesia are minimized in simultaneous Bilateral Total Knee Replacement surgery as both the knees are operated upon on the same day.
• There is shorter rehabilitation period following simultaneous Bilateral Total Knee Replacement

Risks of Bilateral Total Knee Replacement

• Fat embolism – This may result from release of fat into the blood stream when the bone is cut and manipulated for instrumentation and prosthesis.
• Excessive bleeding
• Allergic reaction to general anesthesia
• Infection at the incision site or of the bone (osteomyelitis)

Alternatives to Bilateral Total Knee Replacement

• Pain and anti-inflammatory medications (NSAIDs) – Non-steroidal anti-inflammatory pain medications are available over-the-counter (e.g. Ibuprofen, Motrin, Aleve) or as a prescription (e.g. Celebrex, Bextra). NSAIDs are effective at pain relief (analgesia), and to reduce swelling (anti-inflammatory).
• Intra-articular injections – Two medications are commonly used for this purpose; cortisone and synvisc. These medications can be injected into the knee joint (intra-articularly). They provide temporary relief of pain and inflammation in the knee joint, thus helping through the delay and waiting period before Bilateral Total Knee Replacement surgery.
• Knee Arthroscopy – Arthroscopic surgery of the knee is beneficial (as an alternative to Total Knee Replacement) to relieve mechanical symptoms such as a catching sensation, a giving way, or painful popping. Knee arthroscopy to treat isolated pain, with no other symptoms, can also be beneficial.
• Knee Osteotomy - The idea of an osteotomy is to shift the weight-bearing from the worn out side of the joint to the healthier side.

Now or Never

• For a vast majority of patients having a Bilateral Total Knee Replacement surgery means enjoying a full range of activities pain free, without any fear or worry. However, you have to keep in mind that Bilateral Total Knee Replacement surgery will not allow you to do more than you could before joint problems developed. Bottom line is that you do not have to live with pain and mobility limitations that result from knee arthritis. If you have not obtained desirable results with medication and other conservative treatments, Bilateral Total Knee Replacement may provide the pain relief that you deserve and long for.

Decision to have Bilateral Total Knee Replacement

• The Bilateral Total Knee Replacement recreates almost normal function of the knee, and its main goal is to relieve pain. It may also help to restore motion of both knees and straighten the limbs. However, the benefits and risks to perform single or Bilateral Total Knee Replacement are best to be reviewed during your consultation with your physician to arrive at a final decision.