A recent follow-up visit stayed with me. A patient with severe degeneration in both knees had undergone knee replacement on both sides in a single operation. I had scheduled a wound check for two weeks later, but she walked into the clinic after just one week. She said she was recovering well and hoped to return to work early. She also offered to have her recovery recorded so she could share her experience with other patients.

Shared with the patient's permission.

When both knees are severely deformed, surgeons often perform the replacements in two separate operations. Between the procedures, patients may experience an imbalance. The operated leg has been straightened and its joint space restored, making it longer, while the other leg remains deformed and relatively shorter. Some patients feel uneven or unsteady and wonder why their legs seem different in length after surgery. That imbalance gradually improves after the second side is corrected.

For patients whose health allows it, I may consider replacing both knees in one operation to avoid that interval: one anesthetic, one hospital stay, and correction of both sides at the same time. This approach is not suitable for everyone. I assess heart and lung function, bone quality, the degree of deformity, and the support available during recovery before recommending it.

Operating on both knees does not necessarily take twice as long. Drawing on my experience with the ROSA robotic system and years of surgical practice, I have refined the workflow to substantially reduce the time needed for surgery and anesthesia.

I described this experience, including patient selection and surgical techniques, in a chapter published by IntechOpen in Innovations in Knee Surgery - Arthroplasty, Preservation, and Sports Medicine.

Whether having both knees replaced in one operation is appropriate depends on your individual circumstances. Please discuss the options with your physician.