Bilateral
Bilateral Total Knee Replacement
Jan,27,2011 21:52 Filed in: Knee Replacement
I get a lot of questions about bilateral, or both at the same time, knee replacement. Doctors have really struggled with this concept because doing both at the same time can result in a much more difficult operation. It obviously takes twice as long, can result in more blood loss, more stress on the heart and lungs, and a longer anesthetic. Doing both knees together takes some surgeons three to four hours and can get very tiring. Because of these added complications, many surgeons severely limit the number of bilateral knee replacements they will do - if they will do any at all.
At the Rubin Institute, we have been able to minimize these problems by combining several techniques. The first is the computer navigation I discussed in an earlier post. By doing all the calculations using custom molds before the surgery, we can speed up the measuring process for both knees. Combining this with some innovative, uncemented knee technology, we can eliminate cementing, which can take 15 - 30 minutes per side. These techniques, I believe, have resulted in better alignment and a much quicker procedure. We are able to do both knees in about 90 minutes with a spinal anesthesia, which is generally safer for the patient.
Our early data show better results, in less time, with fewer complications. It’s allowed me to open up this procedure to far more patients than in the past because of the reduction in risk. While doing both knees at the same time does result in more time in the hospital, many patients recover just as quickly from two knees as one. I always caution that this is still major surgery, and can certainly have complications, but it is a much more reasonable option than it was in the past and can benefit a lot of patients.
At the Rubin Institute, we have been able to minimize these problems by combining several techniques. The first is the computer navigation I discussed in an earlier post. By doing all the calculations using custom molds before the surgery, we can speed up the measuring process for both knees. Combining this with some innovative, uncemented knee technology, we can eliminate cementing, which can take 15 - 30 minutes per side. These techniques, I believe, have resulted in better alignment and a much quicker procedure. We are able to do both knees in about 90 minutes with a spinal anesthesia, which is generally safer for the patient.
Our early data show better results, in less time, with fewer complications. It’s allowed me to open up this procedure to far more patients than in the past because of the reduction in risk. While doing both knees at the same time does result in more time in the hospital, many patients recover just as quickly from two knees as one. I always caution that this is still major surgery, and can certainly have complications, but it is a much more reasonable option than it was in the past and can benefit a lot of patients.
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