Bilateral One Staged Total Knee Resurfacing Surgery - Is a Boon or Bane?

My mother aged 65 years has severe arthritis of both knees, should she get both knees replaced in one sitting?

You should do both knees in one sitting if the severity is same in both the knees and the patient is unable to differentiate the painful knee. In case the patient says one knee is more painful than address one knee at a lime. Your own knee is always the best till it lasts.

What are the advantages of doing both the knees in one sitting?

• Exposure to the risk of anaesthesia reduced to only once
• Aids simultaneous rehabilitation especially in severely deformed knees
• Bilateralprocedure reduces cost
• Earlier return to baseline function and convenience for the patient and relatives
• Shorter cumulative hospital stays

What are the risks associated with bilateral Total Knee Replacement (TKR) and are there any studies to support the same?

The risks of cardiac and infection related complications for bilateral TKR are lower than the combined risk of two unilateral TKRs. A population-based comparison of the incidence of adverse outcomes after simultaneous-bilateral and staged-Bilateral Total Knee Arthroplasty published in The Journal of Bone And Joint Surgery.

Result: Records were available for 11.445 simultaneous-bilateral arthroplasty Procedures and 23.715 staged-bilateral procedures.

Conclusions: Simultaneous-bilateral total knee arthroplasty was associated with clinically important reduction in the incidence of infection and malfunction within one year after arthroplasty.

What is the latest Technology available which could help improve surgical outcomes?

Custom Fit Knee Resurfacing: A knee with your name on it i.e. customized specifically based on your dimensions.

Understanding Custom Fit Knee Resurfacing: You are unique and so is your individual anatomy and thus lack of accuracy leads to discomfort and even further corrective surgeries That is why Custom Fit Knee replacement surgery, which utilizes MRI (Magnetic Resonance Imaging) technology to create personalized positioning guides for total Knee replacement is recommended.

Practical Benefits Of Custom Fit Knee Replacement

• MRI of the affected knee is done based on which we can make a customized jig for better fitting of the implant for the patients
• No intra medullary instruments so minimal chances of fat embolism
• Minimally Invasive (just a 4-5 inch incision)
• Improves the speed of the operation theater time (40% reduced surgical time)
• Increases implant inventory efficiency (know sizing)
• Faster recovery of the patient
• Perfect patient alignment thus better mobilization

What is the role of body exhaust 'space' suits in Bilateral TKR?

• 'Space' suits maintain a more sterile environment and offer more mobility to the surgeons.
• Space suits are used to help reduce contamination from the operating teams from entering the wounds.
• The impure air exhaled by the operating team is pushed down by the rotating fan in the helmet of space suits and absorbed by the laminar air flow in the 0.T.