Bilateral knee replacement vs single:not asking advice

Poststructural Pub
1

NOTE-- I am NOT asking for medical advice, just for other people’s experience.
My wife is facing replacement of both knees due to severe, bone on bone arthritis. The only question is if she’ll have them done one at a time, or bite the bullet and do both at once. Our excellent surgeon usually does singles but will do both if she wants, knowing that she has a live in nurse :smiley:. Taking time off from work once rather than twice would be a major advantage, even if that one time is somewhat longer.
I’m curious if anyone here has had two knees replaced simultaneously, or knows anyone who has. How long before you were able to get around reasonably well? Return to moderately sedentary work?

Again, I’m NOT, NOT, asking for advice, just people’s experience.

2

I know of 1 middle-aged-plus person who had both knees replaced at the same time, and was up and ACTIVE very quickly (I think in 5 weeks).

Another did 1 knee, had a considerably painful recovery, and was assisted by her church group for about 2 months. She waited a couple of years before doing the other, also painful and slow. The 1st one also later gave some trouble due to infection.

I think it’s going to depend on your wife’s overall state of health and mind, the specific conditions of the physical structure, the quality of the surgeon and materials, and the care and physical therapy involved. From my 1st example, I’ve seen it go surprisingly well.

3

My wife is facing the same dilemma, perhaps as early as this summer, trying to take advantage of her group health insurance before she retires. I think that she has decided to have both knees done at the same time and hope for the best.

4

I have a friend and a family member who both had bilateral hip replacements, both were in very good physical condition before surgery, recovery was fairly rapid, don’t know how that compares to knee replacements.

5

Hip and knee replacements are different critters. Recovery is more difficult and time consuming for the knees in many cases.

Hip replacements can be approached so that there is minimal cutting of muscle, nerves and connective tissues. In those cases it’s not uncommon for a person to be walking up and down stairs unassisted two days after surgery. My wife has been through that - pretty much a miracle for her.

We know a dozen folks who have been through the replacement of both knees. My wife is accompanying one of these to therapy as I write this. Much of the outcome and recovery has to do with the physical condition of the patient. All but one of these friends has had the knees done one at a time with ample time for recovery from the first before taking on the second. Having both done at the same time seemed a really tough road to take. It gives real meaning to the phrase “doesn’t have a leg to stand on”.

I’ve been dodging the knee replacement specter for a while now myself.

Best of luck, no matter what you decide to do.

Feadoggie

6

My mother (mid-70’s in age, good health) had her first knee replaced in January of 2011 and the 2nd one done a year later. She had a particularly hard time with the first one – it wasn’t so much the knee as the recovery from the surgery itself. We were worried that after that experience she wouldn’t be willing to do the other. The fact that she did have the second one done told us how bad the knee was. The second surgery was a little easier on her; they used some different drugs and she wasn’t so ill afterward, though it was still no walk in the park. It’s now May and she’s just finished her course of rehab. She’s coming to visit and says she’ll take the downstairs room; stairs are no problem now. It’s been a long, difficult recovery for her but we hope that she’ll get to enjoy her bionic superpowers for decades more. Longevity runs in her family, so we hope she’ll be using those knees until she’s 100.

There definitely would have been a plus to only undergoing surgery once, but the knee rehab took a lot of time, pain, and work, and it would have been hard to do both at once. It’s a tough decision. I wish your wife a great outcome, whatever she decides. AND she’s lucky to have you (but she probably knows that! :slight_smile: ).

7

A co-worker of mine, who is in her 50’s, had both knees done at the same time. She was able to go up and down stairs within about three days and managed to cook Thanksgiving dinner for her family two weeks after. She was off work for nine weeks and felt she was pretty much fully recovered when she returned.

She recommends the two-for-one but does have one suggestion. With both knees recovering at the same time it is impossible to get out of low-seated chairs and, especially, toilet seats without using your arms. Acquiring something like this:

http://www.amazon.com/Drive-Medical-Premium-Removable-Standard/dp/B002VWJZ10/ref=pd_sbs_indust_7

is essential before she returns from the hospital.

8

Paul,

I can’t speak to TKR specifically, but I have both knees operated on (for torn lateral meniscus), and I will eventually have to have TKR bilaterally so I have given this a fair amount of thought. I’ll add my experience and thoughts, fwiw.

I had my knees operated on separately and it’s a good thing that I did because I had significant complications both times - protracted patella tendonitis to be exact - which made recovery far longer, years rather than weeks in fact. Had I done both knees at the same time, I would have been screwed from a quality of life perspective because due to the patella tendonitis I was unable to regain strength and muscle mass for years after each surgery. This was when I was in my mid- 20’s and very athletic, which I still am thankfully. But the upshot is that I was hobbled on one side for several years after each surgery, and I would have been totally screwed had I done the procedure bilaterally.

Of course my case was unusual and looking back over the years there has been evidence that I do have a over active inflammatory response. Still TKR, as you know, is a very rough surgery, and if recovery doesn’t go as planned, for whatever reason, having both knees out of commission for a protracted period of time could be a real physical/mental/emotional bummer.

Also, having had multiple surgeries for various things, I find that my body likes the effects of anesthesia less and less every time. I couldn’t urinate for 3 days after my last surgery a couple of years ago, so personally I’d rather spend as little time under as possible during each surgery.

Finally, I found Physical therapy a bitch. I mean rehabbing knees, at least 20 years ago, was very painful. I saw lots of people literally crying as the physical therapists manually worked their legs to get the range of motion back. Honestly, I can’t imagine having to rehab both knees at once, only so much pain one can tolerate at a time. Things may have improved in that sense in recent years, perhaps I was just too stubborn at the time to take my vicodin, I don’t recall :boggle:

My current thoughts are that I’ll do one knee at a time when it comes time to do my TKR’s. That could change, and certainly the allure of getting it over and done with all at once is strong. The fact that your wife has you for support, both physically and emotionally, does make for a stronger case for going the bilateral route - I was, and still am single, so having to rely solely on myself after surgery like this does color my thoughts on the matter rather heavily.

Hmmm, guess all of that probably wasn’t too helpful Paul, but maybe something in there will be useful. Either way, I’m sure your wife will be fine in the long run: Most people I’ve run across who have had TKR said they were glad they did it and they were eventually pain free or at least had much less pain after recovery than they did before having the surgery.

BTW, you might want to ping David Levine on this, I know he had TKR in recent years and you know he won’t candy coat his thoughts on the experience :wink:

Loren

9

All I know, before being there and doing that, I knew it was gonna be tough, after, it’s still tough, but so worth it. It’s still difficult for me to watch friends go though rehab, the consensus is that it’s better than it was!

10

We went to the surgeon yesterday and we’re doing a sort of compromise. Char is not getting both done at once, but she’s not doing one this year and one next year. Instead, she’s having one done (probably mid-June) then the other done a month later. This gets them both out of the way relatively and yet still gives her one good (or at least one month healed) leg to stand on at any given time.