Double knee replacement: your questions answered

Whenever anyone reaches the point that both knees need joint replacement, an obvious question surfaces: why not have them both done at once? Bilateral knee replacement is tempting to many patients who dread recovering from two surgeries. Nevertheless, physicians are still appraising the risks and benefits of double knee replacement, and it’s not an option for everyone.

In today’s post, Jonathan Surdam, MD, an orthopedic surgeon at Indiana University Health Southern Indiana Physicians Orthopedics & Sports Medicine, explains the pros and cons of double knee replacement. 

Can you describe the ideal patient for bilateral knee replacement?

The ideal bilateral patient is someone who is physically fit, and in good overall health, with all comorbid conditions (diabetes, high blood pressure, etc.) under good control. They also need to be very motivated to go through aggressive physical therapy and rehab to reclaim an active lifestyle.

How tough is the physical therapy for bilateral knee replacement?

Our goal is to get patients up and moving as soon as possible following surgery. We try to control pain aggressively with nerve blocks, special injections into the tissue around your new knees and oral pain medication. Rehab tends to be more complex and challenging because you have to recover strength and range of motion on both sides to support you through your gait. Transitioning patients to walk is more difficult because they don’t have a good leg to stand on.

What are the factors that influence people to seek that as a solution?

The most influential factor is word of mouth. Total knee replacements can have a dramatic impact on a patient’s quality of life. After a successful recovery, word spreads quickly. The bilateral procedure is most appealing to people who have limited time off from work for rehabilitation and recovery.  

On a personal level, what do good candidates need to consider before having double knee replacement?

We want to get people in an outpatient setting as soon as possible, so it’s important to establish a strong support system to help with daily living tasks. The challenge of recovery from bilateral knee replacements takes a team approach. You can’t do it by yourself, so we try to help you assemble your team for a successful recovery.

What are some of the drawbacks of having both knees replaced at once?

Several studies suggest that having both knees replaced at the same setting increases your risk of medical complications. Today, I’m doing fewer bilateral replacements than I did 10 years ago. If you have two bad knees, a staged procedure may be easier on you mentally and physically. 

To explore your joint replacement options, join us for one of the many seminars we host around the state. Dr. Surdam will be a seminar speaker on September 9, 2014 at 6 p.m., Bloomington-Monroe County Convention Center, 302 South College Avenue, Bloomington, Indiana. For an appointment with an orthopedic specialist at IU Health, call 317-944-9400.