What Is Outpatient Bilateral Total Knee Replacement
An outpatient bilateral total knee replacement means that the two joints are repaired over time in an outpatient same day surgical center. The goal of a bilateral knee replacement surgery is to remove both affected joints along with any painful arthritis that has formed and replace them with two fully functioning prosthetic knees. Jeffery T. says, The best thing about having this surgery was not having the pain anymore.Knee replacement surgery requires a surgeon to repair the damaged knee joint by replacing the original surface with a prosthesis. The prosthetic is made of metal, ceramic, and plastic and it can restore the function of the knee and eliminate the pain of arthritis. Bilateral knee replacement surgery means that both knees are replaced, sometimes, as in the case of Jeffrey, each knee is repaired consecutively, several months apart.
The knee itself is a complex, weight supporting joint. The knee joint works to bring together the two long bones in the lower and upper leg , holding them at the flex point with muscles, ligaments, and tendons. Each bone is covered by a softer layer of cartilage that works as shock absorbers to keep the bones from rubbing together. Knee replacement removes the damaged portion of the knee itself and replaces it with a prosthesis cemented to the remaining bone.;;
Advantages Of Bilateral Knee Replacement Surgery
Although it may seem like a big undertaking, having both of your knees replaced at the same time does have its advantages. The biggest benefit is the obvious one: significantly less pain than before surgery. Some of the other benefits include:
- May shorten your rehabilitation
- Only one hospitalization for two conditions
- Recovery may be shorter
- Only one leave from your job
Another advantage of having both knees replaced at once is that you can get back to your normal activities much quicker. The rehab and physical therapy is usually much more intense for bilateral surgeries, making your recovery smoother and quicker in the long run.
These advantages are mostly dependent on you and your motivation for recovery. The other big factor is how healthy you are. The younger and healthier you are, the more likely a bilateral knee replacement will work out in your favor.
When Should I Consider A Total Knee Replacement
The best recommendation for your treatment can only be decided by you and your doctor. Whether or not you need surgery is a very personal decision that only you can make with the help of an orthopaedic specialists evaluation of your pain and its effects on your daily life. For example, experiencing knee pain day after day without relief can lead to staying off the joint which often weakens the muscles around it, so it becomes even more difficult to move.
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Knee Replacements At Age 40
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Hi everyone,I had RNY in 2006 in Mexico.; I have lost 130 pounds and have had 20 of those creep back on within the past year.; I was in YMCA Boot Camp last year and my left knee swelled up and I could not walk on it.; I was told I have arthritus in both my knees and have bone on bone in my left.; I have tried everything from braces, physical therapy, shots of all kinds, celebrex. shoe inserts, and lots more.; I have now found a doctor that will do a total replacement on my left knee, but would like me to wait a little longer because I am only 39 years old.; How am I suppose to loose the weight to make myself feel better, when it hurts to walk.; I am in tears after shopping at Walmart.; I can’t go on like this anymore.; Has anyone had experience with a Total Knee replacement at age of 40??; I would love to hear your thoughts on this.; Thanks so much for all your help.
Pros And Cons Of Having Both Knees Replaced At The Same Time
It is essential to be aware of all pros and cons associated with simultaneous bilateral knee replacement surgery before considering it.
Though it finishes-off the work in one go, this type of surgery has its share of benefits and risks. You have to approach it cautiously and go ahead only after a thorough discussion with your doctor.
- More convenient as replacement surgery for both the knees takes place in a single procedure.
- You may need less time off from work. You dont have to repeat office leaves for two surgeries as in the case of staged bilateral surgery.
- The time for recovery after knee replacement surgery is single for both the knees. It means you dont have to wait to get one knee operated and healed and then wait again after the second one.
- You may also enjoy the benefits of reduced cost with a single surgery. Your cost savings can be anywhere between 18% to 26%.
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When Can You Resume Hiking
As is probably the case with most hikers, I find it difficult to sit around and not be active. But I knew I had to deal with some forced downtime here. Driving was out for several weeks and a constant rotation of DVDs and laps around the living room helped to pass the time.
Everyones recovery time is different and your doctor will advise you as to when you can start getting back on your feet again. For me, I took my first steps onto a flat trail about a month after the surgery. A whole half mile! It wasnt much but it was a beginning.
Eventually, those half miles turned into miles, which turned into longer hikes, which turned into some actual hill climbing. By late summer 2018, I had hiked a few White Mountain 4,000 footers and was feeling pretty great.
In retrospect, my activity level was probably ramped up a bit too soon. It can take up to a full year to completely heal, and I was just going on a partial replacement here a full knee overhaul can take longer. Unfortunately for me, I had setbacks regarding pain and limited movement. The prosthesis itself was fine, its just that my mind had gotten ahead to a place that my body wasnt ready for yet.
I was also told that because of the increased activity from hiking, we can expect our replacement parts to wear out a bit quicker than those of folks who are not as active. In the case of a partial replacement, it may have to be later replaced fully. A full replacement may need to be completely redone.
What To Expect After Total Knee Arthroplasty
There is a significant reduction in knee-pain right after the surgery. However, surgery-related pain is mild and temporary and easily managed by pain-killers. Your doctor will check for any signs of infection, blood clots or any other complication that may arise post-surgery, during your hospitalisation.;
Physical therapy will start soon after the surgery to help you with some movement. These sessions aim at building strength and regaining mobility. The therapist will include some knee-strengthening exercises and make you walk gradually. How long you will require physical therapy will depend on your health and progress.
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How The Operation Is Done
The worn ends of the bones in your knee joint are removed;and replaced with metal and plastic parts which have been measured to fit.
You may have either a total or a partial knee replacement. This will depend on how damaged your knee is. Total knee replacements are the most common.
Read more information about what happens on the day of your operation.
Doctors Are Split On Their Opinions Of This Surgery
Some orthopedic surgeons simply will not perform two knee replacements at once, preferring at least a three-month separation between surgeries. Many suggest that age, physical health, and mindset play a role in the final outcome. And that recovery is more demanding for two knees vs. one. There is also evidence that younger patients have a harder time recovering in the short-term, only to do well over the long-term. Other surgeons agree to perform double replacements knowing that it can be better for the patient to just get it done at once so they can get back to their lives more quickly.
The Consequences of this Trend
The problem is that with this seemingly irreversible trend toward doubles, patient results have suffered. Lisa Alarcon, Director of Physical Therapy at Michigan VNA notes that if your knees are bad enough so that one knee cannot really support all of your weight then go ahead and do them both. She also suggests that for rehabilitation, bilateral surgery has it advantages in that you cannot cheat when you are doing your rehab exercises because both knees are in recovery. Patients with two knee replacements at once can do very well in rehab because of this balanced recovery. Of course, there is double the danger of succumbing to scar tissue before you can get to a good range of motion. Lisa discusses the dangers of scar tissue;here.
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What To Expect From Surgery
Having two knees replaced typically takes three or more hours, although every case is individual. During this time the doctor carefully removes damaged bone and cartilage and replaces it with a combination of metal and plastic that enables your new knee to function as closely as possible to how a healthy knee functions.;
Dr. Hood may use robot-assisted technologies or any number of other methods to make the surgery less invasive and lend itself to quicker healing time. Dr. Hood and his team will discuss surgery plans with you beforehand and give a more specific and individual idea of what to expect.;
Pros And Cons Of Simultaneous Bilateral Knee Replacement
Traditional staged TKAs involve two surgeries, two episodes of anesthesia, two hospital stays, and two programs of rehabilitation over the course of a year or so. A key benefit of the simultaneous bilateral TKA is it exposes you to only one surgery and one episode of anesthesia, which can be safer and reduce the risk of infection in some people.
However, researchers have learned simultaneous bilateral TKA poses a higher post-operative risk of blood clots than the staged procedure. When a person has both knees replaced at once, you can imagine how difficult walking and rehabilitation become. Who wants to walk or participate in exercises with two swollen, painful, stiff knees, after all? This difficulty with walking and performing rehabilitation exercises causes double knee replacement patients to become more sedentary than their unilateral TKA counterparts.
When a person is sedentary after orthopedic surgery, their risk for developing , or DVT, rises. DVTs can cause to travel from the legs to the lungs and cause breathing problems, even sudden death. This complication is preventable in most patients.
If youre considering simultaneous bilateral knee replacement, you should discuss all of the risks and benefits with your doctor. Your overall health, co-existing medical conditions, and other factors might make simultaneous bilateral TKA a safer option for you than having two staged procedures. Or, you may find it better to go with the traditional staged process.
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Why Revisions Are More Complex
Revision replacement is difficult for several reasons. First, when someone has surgery, scar tissue develops, and soft tissues become less identifiable. Performing the second surgery is always more difficult. Second, when performing a knee replacement, bone is removed. When performing a revision knee, often more bone has to be removed, and some may be lost as a result of the problem with the implant. Maintaining adequate bone to support the new implant can be a challenge. Finally, obtaining a knee that is flexible enough to allow for motion, yet stable enough to keep you steady, is also more difficult in revision situations.
Trends In Bilateral Replacements
I recently took a look at a;study;on bilateral knee replacement surgery published by Hospital for Special Surgery, where much of the pioneering behind knee replacement was done. I was surprised at what I found. The number of bilateral total knee replacements performed between 1999 and 2008 increased by 75%. In 1999 bilateral procedures accounted for 3.7% of all knee replacement operations. By 2008 they accounted for 6% of operations. The average age for bilateral surgeries during that same time frame decreased by 2.5 years.
Not All Good News
However the rate of comorbidities increased measurably during this time frame. More complications and difficulties were seen for those with two knee replacements. Here is an article that discusses the fact that there can be twice the complications for bilateral patient vs. single knee patients: HSS Article
Obesity as a Factor
Clouding matters further was the fact that obesity increased by 131% during this time frame. It is all related as the number one cause for knee replacement surgery is obesity. Dr. Stavros Memtsoudis, the highly respected orthopedic surgeon who oversaw the study, said patients should critically look at themselves and talk to their physicians about how their health status plays into the choice of surgery.
Ed and Pre-hab before Double TKA
Mike & The Mailbox
Steve & a Fractured Tibia
Betsy, Two Knees, One Knee Per Surgeon
Record Setter Ray
Melissa at 47
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Can You Have Two Knees Replaced At The Same Time
If you have osteoarthritis in both knees, is it better to replace them one at a time, or both together? Yorkshire Knee Clinics Jim Newman has the answer.
The first question is the simplest one to answer. Yes, it is often possible to have both knees replaced at the same time.
The second question whether you should have both knees replaced at the same time is slightly more complex because there is a technical and a personal aspect to the answer.
Improve Your Range Of Motion With Exercise
Your therapist will prescribe exercises to help you move your knee freely. Youll need to get involved in exercises such as:
- Step-ups on stairs
- Leg balances using one foot to stand at a time
- Partial bending of the knee
- Raising your toe and heel while standing
Your goal should be to increase the range of motion to over 110 degrees at 11 weeks. You should be able to increase mobility with little or no pain.
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The Disadvantages Of A Bilateral Knee Replacement
While there are several advantages to having both knees replaced simultaneously, its not for everyone. The common risks associated with a bilateral knee replacement include:
- More blood loss during your procedure
- Longer time spent under general anesthetic
- Increased chances of complications, such as wound infections and blood clots
Plus, when you have both knees replaced at the same time, you also have a more complicated recovery and rehabilitation process. This is due largely because you dont have a good leg to rely on. Approximately two-thirds of men and women who have bilateral knee replacements need to stay at a rehabilitation center compared to one-quarter of those who have one knee replaced at a time.
To learn more about bilateral knee replacement surgery, book an appointment online or over the phone with Chicago Orthopaedics and Sports Medicine today.
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Start Using The Knee Early
Recovery and rehabilitation must start shortly after you awake from surgery. On the first day, you need to start standing up and walking with an assistive device, like a walker or crutches, with the aid of a physical therapist. Use your artificial knee as soon as you can. Your therapist will guide you through exercises that will increase the strength of your muscles, as well as help you get in and out of bed.
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The Pros And Cons Of Double Knee Replacement
Choosing a surgeon that has performed a high volume of knee replacements may increase the likelihood of successful knee replacement surgery. SeeChoosing a Surgeon for Total Knee Replacement
Double knee replacements have similar results to single-knee replacements. Both groups of patients report less knee pain and an improved knee function.1,2 However, there are important differences between having a double knee replacement surgery and two single knee replacement surgeries.
The advantages of bilateral knee replacement tend to be associated with cost and convenience.
Less time off from workPeople who have a double knee replacement only have to schedule one recovery period, and miss less work.
For example, experts suggest that a person may return to a desk job 4 to 6 weeks after knee replacement surgery.3 A person who has two separate knee replacements will take 4 to 6 weeks off work for each knee.
Less time spent in the hospitalDouble knee replacement patients tend to spend at least a half-day longer in the hospital than single knee replacement patients4,5but they only have to stay in the hospital one time. In other words, a double knee replacement might require one 4-day hospital stay while two separate knee replacements might require two 3-day stays .
Who Is A Good Candidate For Bilateral Replacement
The best candidates are those who are active and have strength in the muscles, ligaments and tendons around their knees.
Youll also fare better if your general health is good. Its best if you have few other medical problems, such as any heart or lung disease.
Even then, Dr. Greene says, you should approach simultaneous surgery cautiously.
If youre young, healthy and a risk-taker, you can contemplate doing both knees, he says. I tell people the day of surgery, though, to tell me which knee is worse. That way, if the anesthesiologist tells me we need to stop after one knee ;which actually hasnt happened ;the more symptomatic knee is fixed.
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