WASHINGTON — Knee replacements are on the rise, and so is the debate over the best way to operate.
Traditionally, orthopedic surgeons have done one knee, let it heal, and then performed surgery on the other. But some patients now have the option of doing both knees at once.
“You do it when you can and when it is appropriate for the patient,” says Dr. Mark Madden, an orthopedic surgeon who is the chairman of OrthoVirginia and chief of the medical staff at Reston Hospital Center.
Studies have shown doing both knees at once is cheaper for the patient, but research indicates the possibility of a greater chance of complications. They include “increased bleeding, increased time in surgery, as well as the increased effort needed in rehabilitation,” says Madden.
He says patients have to weigh all the factors in consultation with their health-care providers. There needs to be a careful pre-op work-up, but Madden emphasizes, “Two knees can be done safely, albeit in the right patient.”
In some cases, two surgeons operate in tandem, with each one focusing on one knee. But Madden prefers one surgeon and an assistant doing one knee and then immediately starting on the other.
“This is truly something that will become more and more common over the next 10 to 15 years,” says Madden, noting that as baby boomers and Gen-Xers get older, demand for replacements for arthritic and damaged knees is rising.
Knee replacements are already one of the most common orthopedic procedures performed in the United States. The rate of knee replacements almost doubled between 2000 and 2010, and the Centers for Disease Control and Prevention estimates that more than 700,000 are performed each year.
