The pros and cons of double knee replacement

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Pros


The advantages of bilateral knee replacement tend to be associated with cost and comfort.

Less free time at work

People who have a double knee replacement just have to schedule a recovery period and lose less work.

See the full recovery of knee replacement surgery

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 of rest for each knee

Less time spent in the hospital

Patients with double knee replacement tend to spend at least half a day more in the hospital than patients with a single knee replacement4,6, but only have to stay in the hospital once. In other words, a double knee replacement may require a 4-day hospitalization, while two separate knee replacements may require two 3-day stays (for a total of 6 days).

See the answers to "When can I ...?" For patients with knee replacement

Less time in physiotherapy

People who receive knee replacements should attend physical therapy appointments 2 to 3 times a week for up to 8 weeks. For people who undergo double knee replacement, these appointments are dedicated to rehabilitating both knees. People who undergo two knee replacement surgeries separately require two courses of physical therapy.

See Precautions and tips for postoperative knee replacement.

Recover and maintain the level of physical activity.

Patients with double knee replacement follow a physical therapy regimen and then return to work and the activities they enjoy, without interruption.

See rehabilitation exercises for knee replacement surgery

A person who schedules two separate knee replacement surgeries could rehabilitate the first knee and become frustrated because, just as the first knee feels good, they should undergo a second major surgery.

Decreasing cost

Double knee replacements cost less than two separate surgeries. Experts estimate that a health care cost savings of 18% to 26% .4 The exact out-of-pocket costs can vary widely depending on many factors, including insurance coverage and location.

While the advantages of bilateral knee replacement are attractive to many patients, they should also take into account the disadvantages.

Cons


The disadvantages of bilateral knee replacement tend to be associated with an increase in medical risks, although researchers debate the exact nature and severity of these risks. Patients are advised to ask surgeons about their past experiences with double knee replacements.

More blood loss

Patients with double knee replacement are more likely to need a blood transfusion during surgery. Experts estimate that approximately 40% of people who undergo a double knee replacement need a blood transfusion, compared with about 12% of people who undergo a single knee replacement. 5.6

See what to expect after the knee replacement

Increased risk of complications

Most double and single knee replacement surgeries are successful; however, complications do occur. The risk of complications is greater in people who undergo a bilateral knee replacement4,6.

See risks and complications of total knee replacement

For example, one study found that 3.8% of patients who underwent double knee replacement experienced major complications compared to 2.2% of patients who underwent a single knee replacement.6 Examples of complications include pulmonary embolism, wound infections and the need for a second operation.

Stay in a rehabilitation center.

Approximately ⅔ of patients who have double knee replacements are discharged from a rehabilitation center, in contrast to a quarter of patients with a single knee replacement.6 Numbers may vary by location.

Not all people consider that a stay in a rehabilitation center is a disadvantage: rehabilitation centers offer permanent care, meals, physical therapy and the opportunity to meet other people who have undergone joint replacements. However, many people prefer to be at home. In addition, rehabilitation centers are associated with an increased risk of infection.

Prolonged anesthesia time

Replacing two knees requires more surgical time than replacing one knee, and that means the patient must spend more time under general anesthesia. Increasing anesthesia time increases the risk of complications.

See how to prepare for total knee replacement

No good leg to stand

A person whose knees have been replaced does not have a good leg on which to stand, which makes recovery and rehabilitation more complicated. The person can not rely on a stable leg to stabilize the body while standing, sitting and using a walker or crutches.

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