Bilateral Total Knee Replacement Treatment: A New Way to Look at Surgery

Arthritis is an inflammation of the joints that can affect one joint or multiple joints. It can cause pain and stiffness in the affected area. When these symptoms occur on one or both the knees, it indicates that the cartilage in the joints has worn away. Bilateral total knee replacement treatment is done by the knee surgeon to replace the damaged joints for relieving the symptoms.

During the bilateral total knee surgery replacement treatment, the knee surgeon will replace the damaged areas of the knee joint with an artificial knee called prosthesis which is made up of plastic, metal or ceramic. This will help to restore nearly all function of the damaged knee and relieve the arthritis pain. Often the doctor will recommend this surgery of the pain in the knee has been interfering with the daily activities and has negative effects on the quality of the life of the patients. Most of the times, this surgery is done on people over 60 years as younger people tend to wear out their artificial knees more quickly.

When the severe arthritis affects both the knees, the knee surgeon will suggest the bilateral total knee replacement treatment. However, since it involves more risk so it is typically recommended only for those who are:

  • Physically fit
  • Motivated to undergo the physical therapy and rehabilitation post surgery to regain their mobility
  • In overall good health

The bilateral total knee replacement treatment may involve one surgery or two surgeries. If both the knees are replaced at the same time, this is known as simultaneous bilateral knee replacement. If each knee is replaced at a different time then this is called as a staged bilateral knee replacement. Either the surgery may involve any combination of the total knee replacement or the partial knee replacement. The knee surgeon will help you decide what is best choice for you.

The benefit to have a bilateral total knee surgery in an ideal candidate include only a surgical event with anesthesia, shorter overall hospital stay, and the ability to rehabilitate both the new knee replacements at the same time. The advantage of the bilateral total knee replacement treatment includes the lower stress level for the cardiovascular system i.e. on the heart and lungs as well as a low risk of blood transfusion requirement post surgery. Generally, this procedure is best for the elderly and/or obese patients and those needing serious medical issues. This procedure is not encouraged in the older patients or obese ones with substantial health conditions such as lung, heart and/or vascular disorders as they would be at higher risk for the significant perioperative complications.

The bilateral total knee surgery means that both the knees are replaced at the same time. It is relatively uncommon to have arthritis in both the knees to reach the same degree at the same time wherein a bilateral would be considered by the best knee surgeon. In such cases, the decision to have the bilateral total knee replacement treatment is one of convenience as the one newly operated knee and one knee still painful and stiff from arthritis can make for a difficult recovery.

Arthritis Treatment: 7 Tips Concerning Stem Cells For Arthritis Treatment

A feature article appearing on ABC News (Newcomb “Stem Cell Treatments for Zoo Animals Hold Promise for Humans) underscored the interest that both scientists as well as lay people have in the new technology of using stem cells to repair and treat degenerative conditions.

“We just extract them, concentrate them, wash them and in the same setting readminster them. Inject them in your heart or your knees, wherever you need them,” Dr. Eckhard Alt told ABC Station KTRK-TV in Houston after treating an arthritic pig at the Houston Zoo.”

So… can this technology be applied to humans?

Here are seven tips about stem cells (SCs) for arthritis treatment you might want to know…

1. There are four types of SCs currently being studied. They are embryonic SCs, allogeneic (donor) SCs, induced pluripotential adult SCs, and finally autologous SCs. Of these four, only two, donor SCs and autologous SCs have been used in either animals or humans to treat arthritis.

2. The SC that appears to generate the most interest is the autologous SC. This is the SC that is present in the patient and can be found in bone marrow, periosteum of bone, fat, and peripheral blood. Autologous SCs are referred to as “repair SCs” because these are the SCs that help with the healing process.

3. Arthritis occurs as a result of cartilage degeneration. Various attempts at inducing cartilage healing with SCs have met with mixed results. The results appear to be highly dependent upon the following factors: age of the patient, body mass index (BMI), extent of cartilage loss, and the technical expertise of the center performing the procedure.

4. The processing and administering of SCs for an arthritis problem is more than just getting SCs out and injecting them. There appears to be a need for some type of acute injury to help stimulate the stem cells to multiply and divide.

5. Possible complications of SC treatment can vary. They include the following: infection, rejection, graft versus host reaction, malignancy, and transmission of genetic disease.

6. The need for a cartilage restorative procedure is very evident since the only treatments available currently for osteoarthritis are palliative, meaning pain control only. This is not satisfactory.

7. In the proper hands autologous SC treatment can be successful. Early data indicating an improvement in cartilage thickness in the treatment of osteoarthritis of the knee has been published.

(Wei N, Beard S, Delauter S, Bitner C, Gillis R, Rau L, Miller C, Clark T. Guided Mesenchymal Stem Cell Layering Technique for Treatment of Osteoarthritis of the Knee. J Applied Res. 2011; 11: 44-48)