One of the most asked questions I get during appointments at
Powder River Orthopedics & Spine is if both knees can be replaced (operated on) at once.
My answer has always been the same: I don’t offer this kind of surgery
because studies have shown significantly higher risks in operating on
both knees at once than if doing one knee at a time.
My answer has understandably been frustrating for some patients, especially
those working with a relatively short window to return to work or some
other activity. However, I believe that one of my primary roles as an
orthopedic surgeon is to prevent complications for my patients.
As typical with many areas in medicine, research in this area continues
to evolve and some more recent studies have been published that show replacing
both knees at the same time can be safe in SELECT patients.
This group of select patients includes those who are under 70 years old
without major medical problems like heart disease, diabetes, COPD, smoking
or obesity. After age 70, or with one or more of the medical conditions listed, single
total knee replacement can be done, but complication rates rise significantly
if both knees are operated on at once. When two knee replacements are
done, one after the other, they can be done as soon as eight weeks apart.
So what exactly do the studies show are the risks? The largest recent analyses
used data from anywhere between 8,000 to 200,000 (or more) patients and
shows that there continues to be a slightly higher risk (less than 1%
increase overall) in blood clots, heart attack, lung problems and death.
Fortunately these complications are very rare to begin with. There is
also a longer initial recovery, higher blood loss and increase in initial
postoperative pain. However, when patients who have other risk factors
for these problems are selected out, the rates drop significantly.
On the other hand, when both knees are operated on at once, there is only
one recovery and infection rate to deal with, only one need for a revision
surgery, and readmission to the hospital are similar. Overall time off
rehabilitation time and cost are lower when doing both at one time.
While I certainly don’t believe that replacing both knees at once
is the right choice for everyone, I do understand that in the right patient
it can simplify the process.
I am always happy to discuss in person any questions regarding your particular
situation to determine what would be best in your case.
Expert Orthopedic & Spine Care In Gillette, Wyoming
Dr. Stanford Israelsen is a board-certified orthopedic surgeon at Powder
River Orthopedics & Spine in Gillette, Wyoming. The physicians at
PROS take an innovative and comprehensive approach to the treatment of
acute and chronic orthopedic pain. Have your procedure in our modern
operating rooms at
Campbell County Memorial Hospital or
Powder River Surgery Center.
See the PROS for:
- General orthopedic surgery
- Joint replacement surgery: shoulder, hip, knee and ankle
- Shoulder, elbow, hand and wrist surgery
- Sports Medicine
- Spine surgery and injections, including minimally invasive procedures
- Bunions and great toe arthritis procedures
- Foot and ankle surgery
- Trauma and fracture care
- Workplace injuries
For a consultation, call 307.686.1413 or visit
PROS is a Campbell County Medical Group Clinic with
Campbell County Health.