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oint replacement surgery is commonly performed these days. When they seek medical advice, they have damage to both knee joints. The patients request both knee replacement surgeries at the same time. We have specific criteria to decide if the patient is fit to have both sides of joints replaced at the same time or not. The bilateral procedures had a significantly higher rate of complications than unilateral procedures, almost entirely because of thromboembolic problems. Studies have shown Bilateral TKA had an increased risk for all complications compared with unilateral TKA regardless of health status. For all complications, there was a greater than threefold increase for the first quartile in the healthiest patients. a greater than fourfold increase for the second and third quartiles, and a greater than threefold increase for the fourth quartile (least healthy patients. Therefore, we recommend simultaneous bilateral knee arthroplasty only for patients in ASA classes 1 and 2.
I would like to share when bilateral knee replacements should not be considered:
- Patient with age more than 75 years.
- Haemoglobin of less than 11.
- Those who are insulin-dependent and with blood glucose levels is more than 180mg/dl
- Previous history of clots in the legs and the lungs.
- Renal insufficiency, with a serum creatinine of 1.6 mg/dl.
- Cerebral vascular disease(stroke).
- Chronic liver disease.
- When the patient is on aggressive anticoagulation therapy.
- When the patient has oxygen-dependent pulmonary (lung) disease.
- Poor ejection fraction.
- Those patients who have a body-mass index of more than forty should have only one knee replacement at a time.
- History of congestive heart failure.
- Obstructive sleep apnoea, proven in sleep studies
- Pulmonary artery hypertension.
