With the Right Patients, Simultaneous Bilateral TKA Can Be Safe, Effective

    About 20% of total knee arthroplasty (TKA) patients have severe osteoarthritis symptoms in the contralateral knee at the time of their procedure. They’re going to need a second TKA to relieve those symptoms, so should both knees be done at the same time?

    Maybe, says Imran Ilyas, MD, FRCS, from Al Faisal University in Riyadh, Saudi Arabia – but only if they can meet strict criteria. For example, patients older than age 75, patients with a BMI over 40, and patients with systemic co-morbidities such as cardiac and pulmonary diseases would not be candidates.

    Dr. Ilyas acknowledges that simulataneous bilateral TKA remains controversial, but it can be safe and effective with the right patients. There are no absolute indications for simultaneous bilateral TKAs, he says, but he has a few relative indications:

    • Symptomatic bilateral osteoarthritis in a healthy patient, preferably a patient younger than age 70
    • Severe varus and valgus in both knees

    Patients need to be motivated to undergo simultaneous bilateral TKA and do the intensive physical therapy after the procedure, Dr. Ilyas says, and the surgeon has to be in a practice that supports the simultaneous procedures.

    Click the image above to hear Dr. Ilyas comment on simultaneous bilateral TKA.

    Producer and Director: Michael Bugera; Post Production: Charles J. Maynard