General Question

Buttonstc's avatar

Has anyone had experience with knee replacement surgery ? One knee or two simultaneously?

Asked by Buttonstc (27559points) March 16th, 2010 from iPhone

Any advantages or disadvantages of one at a time vs. both together.

Any other thoughts, advice, tips on any aspect of this would be much appreciated.

What is the most crucial area of this I should research ? Any contacts, websites which you found most helpful.

Educate me from your experience. Don’t hesitate to make your response as lengthy as necessary. I’m a life long avid reader and I won’t be just skimming anything. You’ll have my full attention.

I’m definitely not stingy with the Lurve. I usually pass it out like candy.

I really need to make some decisions about this.

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11 Answers

coogan's avatar

My father didn’t have full replacements. He had the meniscus trimmed because he didn’t have the stones to handle knee replacement. He was right. If you get it done, do them both since you will have the same recovery time for each operation. For his repair job, it was 2–3 days, but he took a week. I don’t know more, but he said the replacement involves cutting the bone above and below the knee, then fuse the artificial joint. As for the attachment of muscles, sounds like physical therapy before you’re doing anything extensive.

Good luck and may the force be with you.

Rarebear's avatar

Most people do it one knee at a time. But there are some centers that are doing two knees at a time, and they pick their patients carefully. I know one guy who had both knees done and he highly recommends it. I know another guy (who is a physician) who also plans on having them both done at once.

Buttonstc's avatar

Do you have any idea what criteria they are using when they are picking which patients are worthy ( for lack of a better word) to get both done simultaneously ?

Or where I could find out if there is a standard protocol for that determination ?

thriftymaid's avatar

I am going to have one knee replaced. I’ve never heard an ortho say he would do both knees at the same time.

gasman's avatar

For bilateral total knee arthroplasty (BTKA) there’s a red flag based on recent clinical research published just last December in the journal Anesthesiology (December 2009 – Volume 111 – Issue 6 – pp 1206–1216)—a major analysis of over half a million cases 1998–2006.

Quoting from the conclusion of the abstract:

BTKAs carry increased risk of perioperative morbidity and mortality compared with unilateral procedures. Staging BTKA procedures during the same hospitalization offers no mortality benefit and may even expose patients to increased morbidity.

That doesn’t mean you shouldn’t have both knees done together—especially if your general health is good and risks are low. And one scholarly article does not settle the issue by itself. But I’d start asking your doctor questions about your concerns. I think it’s more common to schedule the 2nd knee weeks or months after the 1st. I am not, however, a surgeon or any kind of expert on total joint replacement.

Rarebear's avatar

@Buttonstc “standard protocol”—great answer!

No, there’s no standard protocol as far as I know. and @gasman is correct, there is an increased risk of perioperative problems. BUT you only have to go through the surgery once.

In terms of what criteria? Each center is probably different. But generally being relatively young, not overweight and without cardiac issues is a plus.

Buttonstc's avatar

Gasman

That was a very helpful article and as I read through it, there was significant info on which coexistent conditions increase risk.

There were several and the main ones topping the list were being male, over 75 in age, congestive heart failure and a few others none of which apply to me. Apparently men are the weaker sex in this case :)

Yeah, I’ll be having lengthy conversations with several surgeons and anesthesiologists down the road. I’m not in any big hurry.

gasman's avatar

Buttonstc, it sounds like you’re on top of things. Good to know your risks are favorable. Good luck!!

YARNLADY's avatar

My husband had arthroscopic surgery on both his knees, about two years apart. Both surgeries went went well, with full mobility with in the week, and no pain reported.

jerseyangel's avatar

My husband had both knees replaced around 23½ years ago. He did both because the hospital where he had it done in NJ was far from my home and I was pregnant with my 3rd child. At that time, you stayed in the hospital for 3 weeks at least, but he was doing so well, they released him after two weeks. He was 40 at the time and fairly fit, considering he had and still has rheumatoid arthritis. At that time, he swam a lot before surgery. He stayed home from work for around 3 more weeks or so. I know he started back to work earlier than he was suppose to. He had physical therapy. The knees have been working fine all these years. In the past year, he has been having trouble with his right knee. That is not surprising as the plastic that separates the two titanium steel parts was only suppose to last around 15 years.

Before surgery, he was barely able to walk. Afterwards, he raised four children, taking them hiking, carrying them in toddler backpacks. Those new knees definitely improved his quality of life.

gasman's avatar

An article published in the journal Anesthesiology December 2009 concluded:
BTKAs [bilateral total knee arthroplasties] carry increased risk of perioperative morbidity and mortality compared with unilateral procedures. Staging BTKA procedures during the same hospitalization offers no mortality benefit and may even expose patients to increased morbidity.

Medical opinions vary, of course. BTKA is still a common procedure in many hospitals. If I were the patient, I’d wait at least 3–6 months between knees.

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