Does double knee surgery make sense for you?

The idea of having a knee replaced is daunting. But what if both of your knees need repairing? Is one visit to the operating room better than two?

If you are otherwise in good health, it's a conversation worth having with your doctor and rehabilitation team. There are some benefits to replacing both joints during a single surgery (called simultaneous replacement). These include undergoing anesthesia only once, fewer days in the hospital, and only one (albeit prolonged) rehabilitation that lets you resume normal activities sooner than two separate ones. 

Simultaneous replacement can also be a good option if the condition of your joints is so poor that replacing only one joint would still leave you unable to function during physical therapy, thereby slowing your recovery. That said, having two separate operations several months apart (called staged replacement) reduces the frequency of some complications.

In analyzing thousands of knee replacement procedures, Mayo Clinic researchers found that people who have simultaneous knee replacements are more likely to develop dangerous blood clots or die within 30 days than those who have single-knee surgery, although such complications are rare overall. But because the possibility is there, people over 80 and those with cardiovascular or lung disease are usually offered staged procedures. If you have any significant medical risks, you are probably better off having two separate operations.

Because you spend less time in the hospital with simultaneous joint replacement, it is somewhat less costly. But when replacement of both joints is medically necessary, Medicare and most private insurers usually cover either approach.

Whether you have one knee replaced or two, participating in a rehabilitation program will be a major factor in the success of your implant. Think of yourself as an athlete training to come back from an injury. Several times a day, you will need to perform exercises your physical therapist has recommended to restore movement in the knee joint and strengthen the surrounding muscles. In addition, ask your doctor how soon you can return to specific activities such as driving, work, sex, or sports, and what you'll need to do to achieve those goals.

For more details on your options when considering joint replacement surgery, including nonsurgical treatments, purchase  Knees and Hips, a Special Health Report from Harvard Medical School.

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