Double, Total Knee Replacement

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Double knee replacement surgery can be performed through one or two surgeries. A simultaneously staged procedure is when both knee replacements occur during one day, under one round of anesthesia. Staged bilateral total knee replacement occurs as two separate procedures, several months apart. In both surgeries, an artificial knee (prosthesis) is implanted to replace the damaged joint.

What is it?

When a patient is experiencing chronic knee pain caused by arthritis, a total knee replacement is necessary. There are many techniques used to conduct total knee replacement surgery, and it is, therefore, appropriate to consult a doctor or surgeon to determine which procedures are necessary. Total knee replacement involves resurfacing the knee and implanting where the cartilage and bone were removed.

What should I do to prepare?

Prior to a double knee replacement, a patient should meet with his or her doctor and discuss x-rays, current medications, allergies, past medical history and other diagnostic tests. Patients are instructed to stop eating or drinking before midnight the day before surgery and to stop taking blood-thinning medications and aspirin in advance of the procedure. Another important preparative measure is selecting which type of anesthesia to use, general or spinal. General anesthesia is a method of complete sedation that is administered through a central line directly to the bloodstream. Spinal anesthesia, or regional anesthesia, is similar to an epidural injection, which numbs a region of the body.

What happens during the process?

General anesthesia is recommended for a double knee replacement. Knee replacements may be performed simultaneously or staged. Simultaneous double knee replacements are conducted so that both knees undergo operation during one dose of anesthesia whereas a staged double knee replacement is when each knee operation occurs separately, requiring multiple doses of anesthesia. During this procedure, a surgeon will remove damaged cartilage and bone to resurface the knee. The surgeon begins by opening the surgical region to access the knee.  The surgeon uses specialized tools for the removal of the arthritic ends of the bone, which will vary in severity depending on the patient. The surgeon then inserts metal or plastic implants, replacing the damaged cartilage and bone, thus restoring functionality of the knees.

What are the risks and potential complications?

Total double knee replacement comes with associated risks, that include, but are not limited to:

  • Blood clots
  • Infections
  • Falls after surgery
  • Knee pain
  • Inability to regain knee function


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