Risk and benefits of bilateral total knee replacement surgery

Abstract

Bilateral total knee replacements can be performed under the same anaesthetic or so-called “single-stage” (simultaneously or sequentially); or under different anaesthetics or so-called “staged” (during the same or different hospitalizations). The main advantages of single-stage bilateral total knee replacement surgery include good clinical results, the need for a single anaesthetic, lower total amount of pain medication used, shorter overall surgical and rehabilitation time, high patient satisfaction, and possibly lower total cost. The drawbacks of single-stage bilateral total knee replacement surgery include increased risk of perioperative complications. Our institutional guidelines for the selection of patients being considered for single-stage bilateral knee arthroplasty contemplate the exclusion of patients of extreme age—patients with significant end organ dysfunction (i.e. ASA physical status of 3 or greater).