Knee arthritis commonly presents bilaterally and many patients require replacement of both knees. A common question is whether this should be done in one surgery (bilateral knee replacement) vs two operations separated by a period of rehabilitation.

Bilateral knee replacement is a good option if

  • You have significant symptoms and signs of arthritis in both knees
  • Your age is under 75 years of age
  • You are in good health (absence of major medical conditions)
  • You are happy to trade a more intensive rehabilitation period for the benefit of only undergoing surgery once
  • If you do not meet this criteria it is a safer option to undergo each knee replacement separately, with a period of rehabilitation in between.

The major concern with bilateral knee replacement is the associated medical risks (Heart attack, blood clots in the legs or lungs, infection, pneumonia or death). Numerous studies have looked at these rare risks and whether having both knee replaced at once is associated with more risk than two individual surgeries. There is possibly, a very small increased rate of the above complications with bilateral knee replacement hence it is important to choose fit, younger patients for this procedure. I have provided links to relevant large studies in The Journal of Arthroplasty and Acta Orthopaedica.

In summary bilateral total knee replacement is a good option if you meet the above criteria. It can provide a quality of life improvement by getting your surgery done in one rehabilitation period, letting you get back to the activities in your life that matter.