7 March: Q&A with Mr Ram Venkatesh

I’m a 78-year-old man who needs knee replacement surgery. It has got to the point that I can hardly walk and it’s very painful getting in and out of a chair.  My GP has suggested that I think about getting both knees done at the same time. Would you recommend this?

Mr Ram Venkatesh, Consultant Orthopaedic Surgeon, Spire Leeds Hospital

The primary aim of a knee replacement is to relieve pain and regain function in a joint where there is established arthritis and all non-operative treatment has failed. Knee replacements could be partial or total and there are no strict age limitations to offer surgery.

When both knees need replacements, the surgeon might consider one of two options. The first option is to perform staged procedures, replacing the most painful knee first and then the second knee several weeks later. The second option is to perform both knees simultaneously or sequentially under the same anaesthesia. The decision would be made by your surgeon based on your medical fitness.

Bilateral simultaneous knee replacements offers benefits of one hospital stay, one anaesthesia and earlier return to active life. The risks of performing both knees on the same day are that the operation duration is longer with higher blood loss and increased risks on the cardiovascular system and lungs. Fine bone debris or fat enter the blood stream during preparation of the thigh bone and may cause some early problems after surgery. Rehabilitation may be initially difficult with two operated knees, though simultaneous correction can help regain earlier function.

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Mr Ram Venkatesh
Mr Ram Venkatesh, Consultant Orthopaedic Surgeon, Spire Leeds Hospital

Mr Ram Venkatesh, Consultant Orthopaedic Surgeon, Spire Leeds Hospital

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