Two Knee Replacements At Once: The Good And The Bad
So would you like one knee, or two?
It is called bilateral knee replacement. Two knees. At the same time. Usually, it is performed by one surgeon at times it is done simultaneously by two surgeons. And it is a massive trend in knee replacement nowadays. We discuss the merits of doing two knee replacements at once below. And we have included the stories of a few recent bilateral knee patients to help you decide if you want one lump or two.
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Learn About The Procedure
Talk to your doctor. Learn what to expect before, during, and after surgery. Your questions may include:
- What is the process for being admitted to the hospital?
- What type of anesthesia will I receive?
- What type of implant or prosthesis will be used?
- How long will I stay in the hospital?
- How long will my recovery take?
- How will my pain be managed after surgery?
In addition, do not hesitate to voice concerns or speak up if you do not understand something about your treatment. Total Joint Replacement: Questions Patients Should Ask Their Surgeon can help guide you in your discussions with your doctor.
Technical Details Of Total Knee Replacement
Total knee replacement surgery begins by performing a sterile preparation of the skin over the knee to prevent infection. This is followed by inflation of a tourniquet to prevent blood loss during the operation.
Next, a well-positioned skin incision–typically 6-7 in length though this varies with the patients size and the complexity of the knee problem–is made down the front of the knee and the knee joint is inspected.
Next, specialized alignment rods and cutting jigs are used to remove enough bone from the end of the femur , the top of the tibia , and the underside of the patella to allow placement of the joint replacement implants. Proper sizing and alignment of the implants, as well as balancing of the knee ligaments, all are critical for normal post-operative function and good pain relief. Again, these steps are complex and considerable experience in total knee replacement is required in order to make sure they are done reliably, case after case. Provisional implant components are placed without bone cement to make sure they fit well against the bones and are well aligned. At this time, good function–including full flexion , extension , and ligament balance–is verified.
Finally, the bone is cleaned using saline solution and the joint replacement components are cemented into place using polymethylmethacrylate bone cement. The surgical incision is closed using stitches and staples.
Length of total knee replacement surgery
Pain and pain management
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Exercises To Do Before Your Knee Replacement Surgery
You may think you have everything you need to buy before a knee replacement, like a grab bar or a sock aid, or maybe you even purchased a knee kit. But youre not done preparing yet! While those products will help you care for yourself after your knee replacement, these pre-surgery exercises will help your knee recover after surgery.
Cram That Cardio And Get In Shpare For An Expedited Recovery
Get your blood pumping! This goes hand in hand with the next section. Strengthening your heart and lungs is important because post-surgery they have to work twice as hard to heal you.
The stronger your heart and lungs are the better they can supply the necessary supply of blood and oxygen through your body for a speedy recovery. Your body will be stronger, healthier, and happier after surgery.
Simply put, the better shape and most weight loss you can achieve the faster your recovery will be. You might be asking how you can exercise when your knee hurts.
Tip: We recommend using a recumbent elliptical to decrease forces on the knee while still getting all of the benefits from exercise.
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S To Take Before Your Surgery
We recommend taking the following actions to ensure your joint replacement surgery is as smooth and successful as possible.
1. Decrease medication use per doctors orders. Before joint replacement surgery, your doctor may ask you to cut down or stop taking certain medications, including opioid medications, steroids, blood thinners, and NSAIDs . If you use any vitamins, nutritional supplements, or alternative medicines, let your doctor know beforehand. You may need to stop using those as well surrounding your surgery.
2. Cut down on smoking and alcohol use. Prepare your body to be in the best condition possible for knee surgery. Smoking and tobacco use slows down the healing process and increases the risk of post-op complications like infections and blood clots. Excessive alcohol use can interfere with anesthesia and medications, slow down the healing process, and increase the risk of post-op infections. If you smoke or drink heavily, talk to your doctor well ahead of surgery to discuss methods for cutting back or quitting completely.
4. Prepare your homes exterior. Prepare the outside of your home to be safe and secure. If you have steps leading to the front door, make sure the steps and railings are in good condition to reduce the risk of slip and falls. Make sure the driveway and walkways are clean and clear, and take note of uneven areas to avoid. If you normally do the yardwork yourself, arrange for someone else to take care of it during the months youre recovering.
What Do Care Coordinators Do
Care Coordinators are regulated health professionals that are experts in nursing, home support, social work, occupational therapy, physiotherapy, and/or speech therapy. They act as your guide for your recovery once you are declared a patient. Your Care Coordinator will assess your health care needs based on your current living arrangements and support system, and develop a plan to make sure you receive the care that you require.
Services that your Care Coordinator may help you with include:
A Care Coordinator will be assigned to you and acts as your point-of-contact in obtaining health care services and information. If you find that your needs have changed prior to your surgery or during your recovery, your Care Coordinator is the person to contact.
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How Much Should I Be Walking After A Knee Replacement
Strictly speaking, there is no limit to the amount of walking that you can do following a knee replacement. Your surgeon will not place a distance or time limit on your walking activities, as most patients find that their knee that is still recovering from surgery, and this will limit them instead. Walking is an excellent exercise to help promote recovery and healing in the knee and many patients find that the more walking that they can do, the quicker they recover from the surgery and the more functional they are in the long term. However, walking should also be supplemented with other exercises that demand a greater range of motion out of the knee such as a stationary bike or an elliptical trainer.
What Is A Total Knee Replacement
A total knee replacement replaces the worn ends of the bones where they meet at the knee. Those bones are the thighbone and the lower leg bone . Your doctor will remove the damaged bone. Then your doctor will replace it with plastic and metal parts. These new parts may be attached to your bones with cement.
Your doctor will make a cut down the center of your knee. This cut is called an incision. It will be several inches long. Sometimes the surgery can be done with a smaller incision. Both kinds of incisions leave scars that usually fade with time.
Your doctor will let you know if you will stay in the hospital or if you can go home the day of surgery. If you have both knees done at the same time, you may need to be in the hospital for a few days.
Most people go back to normal activities or work in 4 to 16 weeks. This depends on your health. It also depends on how well your knee does in your rehab program. This may take longer if you have both knees done at the same time.
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What Are Some Exercises That Can Be Done
There are a variety of mobility exercises and flexibility exercises for you to perform, which can help with injury prevention. These were recommended in a separate article, Prehab Exercises to Perform at Home. We recommend speaking with your physician or a physical therapist before performing these, as a therapist can help make sure youre doing them with proper form and select the exercises that are best for your unique needs.
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What Kind Of Physical Therapist Do I Need
Although all physical therapists are prepared through education and experience to treat people who have a total knee replacement surgery, you may want to consider:
- A physical therapist who is experienced in treating people with orthopedic, or musculoskeletal, problems
- A physical therapist who is a board-certified clinical specialist or who has completed a residency or fellowship in orthopedic physical therapy, giving the physical therapist advanced knowledge, experience, and skills that may apply to your condition
You can find physical therapists who have these and other credentials by using Find a PT, the online tool built by the American Physical Therapy Association to help you search for physical therapists with specific clinical expertise in your geographic area.
General tips when you’re looking for a physical therapist:
- Get recommendations from family and friends or from other health care providers.
- When you contact a physical therapy clinic for an appointment, ask about the physical therapist’s experience in helping people with knee replacements.
During your first visit with the physical therapist, be prepared to describe your symptoms in as much detail as possible, and say what makes your symptoms worse.
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What Can I Do To Help My Recovery After Knee Replacement
Soon after surgery, you will be able to walk with a cane or a walker. But you will need help with everyday activities, such as:
Plan ahead to have a friend or loved one help you after surgery, or tell your healthcare provider if youll need help.
Your recovery will also be easier and safer if you adjust your home ahead of time. Things to consider include:
- Bench or chair in the shower, as well as secure safety bars.
- No tripping hazards, like cords and loose carpets.
- Secure handrails along any stairs if you use stairs.
- Stable chair with a back, two arms and a firm seat cushion, along with a footstool to elevate your leg.
- AVOID reclining chairs as they DO NOT allow for proper elevation of your post surgical leg.
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Different Types Of Surgery
There are 5 main types of knee replacement surgery:
- Total knee replacement. This is the most common form. Your surgeon replaces the surfaces of the thigh bone and shin bone that connects to the knee.
- Partial knee replacement. If arthritis affects only one side of your knee, this surgery may be a possibility. However, itâs only right for you if you have strong knee ligaments and the rest of the cartilage in the knee is normal. Partial knee replacement can be performed through a smaller cut than is needed for total knee replacement.
- Patellofemoral replacement. This replaces only the under-surface of the kneecap and the groove the kneecap sits in. This can be very effective for people with chronic kneecap arthritis.
- Complex knee replacement. This procedure may be needed if you have very severe arthritis or if youâve already had two or three knee replacement surgeries.
- Cartilage restoration: Sometimes when the knee only has an isolated area of injury or wear this area can be replaced with a living cartilage graft or cells which grow into cartilage.
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Massage Around The Knee Often
Massage definitely was a plus in my recovery. My caregiver usually gave me at least one extended massage on the sides of my knee and on the back of my knee.
I massaged my knee myself before my 3 daily exercise sessions. A massage right before bedtime also felt great.
I used the product Free Up Massage Cream that my therapist recommended. Other kinds of lotion or cream work well too.
Lose As Much Weight As Possible
What happens if you are lifting a vehicle up to work on it and the jack cannot support the weight of the car? The jack breaks and the car crashes to the ground. The same thing can happen with your knee joints.
Your knees are one of the most important joints in your body. They help you walk, bend, and make a great lap for your grandchildren to sit on. Reducing the amount of weight that is being put on your joints will significantly improve your quality of life.
For every 10 pounds of weight loss, it equals 40 pounds of weight reduction on your knee joint.
With less weight, you move around better and your overall health will improve. People often take their physical health for granted until something no longer works properly or causes them pain.
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Have Your Cane Walker Or Walking Poles Ready
Make a point to get walking poles, a cane or a walker. Dont go to the hospital without a cane, walker, or walking pole waiting ready to use when you come home.
Its too late if youre ordering one of these after you get home. You need it ready-to-go as soon as you arrive at your home.
It will be your best friend on visits to the shower or toilet. It will help you get to your favorite recliner and assist you getting to the fridge for a snack.
Most people will be more comfortable with a walker or cane because they can handle more of your body weight. I used walking poles which helped a great deal for balance but due to the poles being taller the amount of pressure I applied to the poles was less
Find Comfort After Knee Replacement Surgery
When you arrive home after surgery, youll feel groggy, a little pain , tired from sleepless nights, possibly irritable, and you wont be walking around well.
To be honest I was happy to leave the hospital and arrive home. I noticed immediately that Id no longer have nurses available for me 24 hours a day. Luckily my spouse was there to help me out but she needed sleep too!
We prepared well and had the house in order. Things were tidy, clean, and we moved some furniture to anticipate my limited movement. We planned out meals and kept important things like medicine, ice, and walking poles close by.
Below is a list of things we did to make things more convenient at home after knee replacement surgery. I recommend implementing the items on this list up to a week before because its too much to do in a single day. Each item is important in its own way. Feel free to use this list as a checklist as you prepare for the big day!
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Can Rehabilitation Be Done At Home
All patients are given a set of home exercises to do between supervised physical therapy sessions and the home exercises make up an important part of the recovery process. However, supervised therapy–which is best done in an outpatient physical therapy studio–is extremely helpful and those patients who are able to attend outpatient therapy are encouraged to do so.
For patients who are unable to attend outpatient physical therapy, home physical therapy is arranged.
Pain Or Swelling After Exercise
You may experience knee pain or swelling after exercise or activity. You can relieve this by elevating your leg and applying ice wrapped in a towel.
Exercise and activity should consistently improve your strength and mobility. If you have any questions or problems, contact your orthopaedic surgeon or physical therapist.
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Before Your Knee Replacement Surgery
Once you and your orthopedic doctor have decided that knee replacement is the right decision for you, you will have to schedule your surgery. Prior to your knee replacement surgery, you will be instructed on how to prepare for the surgery and what to expect after the procedure. Your orthopedic surgeon will suggest you to do some prehabilitation exercises, which will include stretching, strength training and other light exercises. You should follow the pre-surgery instructions and exercise program as it will help you get as healthy as possible prior to your surgery. The better your knees are before your surgery, the more quickly your body will recover and adapt to the new knees .
Preparing Yourself For Knee Replacement Surgery
Dr. Tiberi offers a surgery preparation app called Peerwell. Patients can use the application on their mobile devices and tablets to prepare for knee replacement surgery, step by step. Dr. Tiberi is able to customize the information for each patient so that they receive tailored instructions on preparing for surgery and recovery.
Peerwell helps Dr. Tiberis patients prepare by providing daily modules to complete in the weeks leading up to surgery. Dr. Tiberi has found that this step-by-step preparation method helps his patients feel less overwhelmed by the pre-op materials, because the information is broken down into segments. When patients are well-prepared before knee replacement surgery, they tend to have better outcomes after surgery.
Preparation modules in Peerwell cover information on the following topics:
Dr. Tiberi and his team will also be available to answer any questions you may have during the preparation process.
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