Thursday, 18 October 2012

Bilateral knee replacement



       Bilateral knee replacement surgery means that both knees are replaced at the same time. But it’s not very common to have the arthritis in both knees reach the same degree at the same time where a bilateral would be a consideration. The decision to have a bilateral replacement done is one of convenience since having one newly operated knee and one knee still painful and stiff from arthritis doesn’t make life easy during recovery.


       Before committing to the surgery, patients should consider the pros and the cons of consenting to the bilateral knee surgery. Bilateral knee replacement is a much longer surgery. One knee takes about 1½ to 2 hrs therefore a bilateral will take 3-4 hours. This is a long time on the table and a long anesthetic which might not be well tolerated by physically compromised patients (such as those with cardiovascular problems, pulmonary disease or are a frail 80+).
Support Considerations:
 
        Even more than a single knee replacement surgery, bilateral knee replacement surgery requires the patient to have a strong home team (either hired nursing and therapeutic support or household members). The physical and emotional support necessary for several weeks following a bilateral surgery is vital to achieving recovery.
Bilateral Knee Joint Surgical Procedure:


        In recent years, high tech equipment such as laparoscopic or endoscopic equipment and computer assisted surgery, also known as CAS, offers minimally invasive surgical techniques that are especially beneficial to those undergoing a bilateral knee joint replacement. Such procedures cause less tissue damage, reduce recovery time and enable the patient to get up and back on his feet more quickly.
Computer assisted surgery is utilized through the use of electromagnetic tools and infrared cameras that display images of the knee on a monitor or camera in the operating room. These images are transported through a small tube such as an endoscope, which allows the surgeon to view the operating field without the necessity of making a large incision. In most cases, incisions for laparoscopic, endoscopic or CAS-type surgical procedures range about one-half inch in length.
Knee replacement surgery requires a hospital stay and is generally performed under general anesthesia. The physician will make an incision and remove the damaged parts of the knee joint, replacing them with a metal or plastic prosthesis. Upon completion of the procedure, the incision is closed and a drain tube placed into the incision site to help remove buildup of fluid.
It is very important for patients to begin using their new knee joint soon after surgery. Physical therapy involving range of motion as well as walking as soon as possible will help to facilitate healing and mobility.
Who Performs Bilateral Knee Replacement Surgeries?

Orthopedic surgeries have developed a multitude of various sub-surgeries and sub-specialties, including hand, foot and back surgeries. Careful research and knowledge will help patients to understand the process they are going through, as well as to provide in-depth knowledge of surgical and healing processes. Orthopedic surgeons perform all types of orthopedic surgical procedures including knee surgeries. Potential patients should check to make sure their physician is certified with State, Provincial, or National Board of Orthopedic surgeon organizations or associations in their country of origin.



Benefits
The advantages of having a Simultaneous procedure include: only one surgical event, single anesthesia, shorter overall hospital stay and the possibility of rehabilitating the patient symmetrically.
The advantages of having a Staged procedure include apparently lower stress level for the cardiovascular system, less complications related with the heart and the deep veins, as well as lower possibility of requiring banked blood after surgery. This is an excellent choice for a patients with cardiac, vascular or pulmonary diseases or above 80 years old.

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