Recovering from a double knee replacement

Are you in need of a double knee replacement surgery or what’s called a bilateral simultaneous knee replacement, but you’re not quite sure what it entails? People with moderate to severe arthritis in both knees may consider a double knee replacement. We interviewed orthopaedic surgeon Mr Jonathan Monk to tell us more.

In the past, if a patient needed to have both knees replaced, both were replaced sequentially, one after the other and rarely at the same time. More recently, some surgeons are replacing both knees at the same time. Two surgeons work simultaneously on one knee each or one surgeon works on one knee and then operates on the other in one sitting. The main advantage of a double knee replacement is that patients only have to undergo one operation, however, rehabilitation time following the operation can be longer.

Advantages of a double knee replacement:

• Less time off work. Only one recovery period needs to be scheduled as the two knees are operated on in one sitting, as opposed to scheduling two separate recovery periods for two separate knee replacements.
• Less time spent in hospital, so less costly. A double knee replacement requires a longer hospital stay than two single replacements, but two separate replacements require two hospital stays, which in the long run is more expensive.
• Less time in physical therapy. Patients who have both knees replaced at the same time can avail of rehabilitation for both knees at one time.

Disadvantages of a double knee replacement:

• The risk of more blood loss. Patients having double knee replacements are more likely to need a blood transfusion following the operation.
• Rehabilitation can last longer.
• Replacing two knees in one sitting requires more time under anaesthesia, which increases the risk of complications.

Mr Monk recommends determining which knee is worse and operating on that knee before treating the other. Often, if one knee has improved function after the operation, the other knee doesn’t require an operation as quickly. Either way, all treatment should be tailored to the patient’s needs.

What can help with recovery following a knee replacement?

Patients react to the pain of a knee replacement very differently. Those who curtail regular exercise and long walks due to knee pain before operation are actually decreasing their muscle function by walking shorter distances. There is an increasing trend where patients who attend physio before an operation optimise their muscle function and reduce their recovery time. Pre-rehabilitation can greatly reduce recovery time following knee replacement surgery.

Mr Monk suggests that recovery is divided into three different stages, following a knee replacement:

• In the first two weeks, the knee needs to recover from the physical challenge of the operation. While the skin is healing, the soft tissue of the muscles start to repair themselves.
• Physiotherapy should begin immediately and then be stepped up between two and six weeks after the operation to regain the range of movement in the knee. This stage is very important to counteract the tendency of the knee to stiffen up.
• After six weeks patients are encouraged to walk as much as they can in order to regain optimal function of the knee.

<p class="read-more"> <a href="https://www.topdoctors.co.uk/medical-articles/back-in-action-how-enhanced-recovery-after-surgery-works">More on recovery<i class="fa fa-angle-right"></i></a> </p>

What advice have you for people who are anxious about their knee replacement?

It’s completely normal for patients to feel nervous or concerned about a knee replacement.

Getting as much information as possible, regarding the experience of other people can be invaluable to reassure other patients. Actress Judi Dench, who was treated by Mr Monk, shares her experience of her knee replacement before a movie Premiere; “my knee operation went very smoothly, by 6 weeks after the surgery I was able to go to the Premiere and very few people realised I’d had the operation”.

If you’d like to find out more about double knee replacements, visit Mr Jonathan Monk’s profile.

<style>.read-more a {transition: background-color 0.5s ease; padding: 8px; text-transform: uppercase; color: #009bde; box-shadow: 2px 2px 10px rgba(0,0,0, 0.2); font-size: 14px} .read-more a:hover {background-color: #f0f0f0} .read-more {text-align: right; margin: 25px 0px}</style>