Overview
Arthritis is a condition characterised by joint inflammation, which can affect a single joint or multiple joints, leading to discomfort and stiffness. When arthritis impacts one or both knees, it typically signals that the cartilage within the joints has deteriorated. Knee replacement surgery is a procedure designed to substitute the damaged joints and alleviate these symptoms.
During this surgery, the surgeon removes the damaged portions of the knee joint and replaces them with an artificial implant known as a prosthesis. These prostheses are constructed from materials such as metal, plastic, and ceramic. They can significantly improve knee function and reduce arthritis-related pain. .
During this surgery, the surgeon removes the damaged portions of the knee joint and replaces them with an artificial implant known as a prosthesis. These prostheses are constructed from materials such as metal, plastic, and ceramic. They can significantly improve knee function and reduce arthritis-related pain.
In cases where arthritis severely affects both knees, doctors might propose double knee replacement surgery. Due to the heightened risks associated with this procedure, it is generally recommended for individuals who are:
- In good physical condition
- In overall excellent health
- Committed to undergoing physical therapy and rehabilitation post-surgery to regain mobility
Types of Double Knee Replacement Surgery
Double knee replacement can be performed through one of two approaches:
Simultaneous Bilateral Knee Replacement. In this method, both knees are replaced during the same surgical session.
Staged Bilateral Knee Replacement. Here, each knee is replaced in separate surgeries, conducted months apart.
Each approach may involve either a total or partial knee replacement for one or both knees.
Simultaneous Bilateral Knee Replacement
This approach involves replacing both knees in a single surgery. Its key advantage lies in the fact that only one hospital stay and one rehabilitation period are required to address both knees.
However, recovery may be more challenging as it involves rehabilitating both knees simultaneously. Many individuals require assistance at home during the recovery phase.
This surgery generally takes longer, lasting about three to four hours, compared to the two-hour duration for each surgery in the staged approach. The longer surgical time and higher doses of anaesthesia increase the risk of complications. For this reason, simultaneous knee replacement is not recommended for individuals with conditions such as heart or lung disease, as these groups face a higher likelihood of heart complications or significant blood loss during and after the procedure.
Staged Bilateral Knee Replacement
This approach involves replacing each knee in separate surgeries conducted months apart. Each surgery typically lasts around two hours, allowing one knee to recover before addressing the second.
The primary benefit of this method is the reduced risk of complications. Additionally, the hospital stay is shorter for each surgery.
However, staged bilateral knee replacement requires undergoing two separate procedures, resulting in an extended overall recovery time. This delay may prolong the period before patients can return to their usual activities.
Risks of Double Knee Replacement
Both simultaneous and staged double knee replacement surgeries carry risks, including:
- Infection
- Blood clots
- Heart attack
- Stroke
- Nerve damage
- Failure of the artificial joint
- Potential need for blood transfusion
Individuals over the age of 65 face a higher likelihood of experiencing complications, and men are generally at greater risk than women.
Recovery and Rehabilitation
Hospital Stay
After surgery, patients are monitored in a recovery room for a few hours before being transferred to their hospital room. Hospitalisation typically lasts 3–5 days for staged surgeries and up to 10 days for simultaneous surgeries. During this period, medications are provided to manage pain, and doctors monitor for complications like infection or blood clots.
Physical Therapy
Physical therapy begins shortly after surgery, sometimes within hours, to help patients regain knee movement. Therapy programs generally last 6–12 weeks but can extend based on individual progress and preexisting physical conditions.
Therapy regimens often include:
- Walking plans to improve mobility
- Knee-strengthening exercises to restore movement and build strength
- Activities designed to aid everyday functions, such as climbing stairs
- A physical therapist guides patients through these exercises, gradually increasing their ability to perform daily tasks.
Following the instructions of healthcare providers is essential during rehabilitation. Adherence ensures a smoother recovery and maximises the success of the procedure.
What to Expect
When you arrive at the hospital, you’ll change into a gown and receive either a spinal block, which numbs the lower half of your body, or general anaesthesia to induce a sleep-like state. Numbing medications may also be administered around the joint to reduce post-surgery pain.
During the Procedure
The surgery typically lasts 1 to 2 hours. During the operation, the surgeon:
- Makes an incision over the knee.
- Removes damaged bone and cartilage, preserving healthy bone.
- Implants the artificial components into the thighbone, shinbone, and kneecap.
Recovery Timeline
Most patients fully recover within 8 to 12 months, though recovery times can vary depending on factors such as age and overall health.
