My children are trying to talk me out of having both my knees replaced at the same time. They say it’s too dangerous and too much at my age. I’m 75-years-old but in reasonably good health. The fact that my arthritis keeps me from enjoying life has motivated me to take this plunge. What do the experts have to say about it?

With today’s improved surgical technology, patients have the option of bilateral total knee replacement (TKR) at the same time. This can be done by one surgical team doing both knees (first one, then the other) in the same operation. Or there can be two surgical teams working on both knees at the same time.

There are some concerns to consider. The overall rate of complications is greater for bilateral TKR compared with unilateral or staged bilateral procedures. Staged bilateral refers to having both knees replaced but they are done one at a time with a certain time interval (weeks to months) between procedures. The number of patients sent to the intensive care unit (ICU) is higher with simultaneous TKRs. The number of days they stay in ICU is also greater for bilateral versus unilateral TKR.

The risk of cardiac complications in patients having bilateral TKRs is four times the risk for those having one knee done. The risk of heart problems increases with age. There are several reasons for this. Heart disease is more common as we age. And the heart and lungs have less reserve capacity to respond to the stress of surgery.

On the plus side, there is less anesthesia used with bilateral simultaneous TKRs. Improved surgical technique means less blood loss. And rehab has to be done for both knees anyway. So the total length of time in recovery is less. There are fewer days of pain and a shorter hospital stay with fewer costs.

When making the decision to replace both knees at the same time, there are many factors to consider. Your overall health and the presence of any other medical problems or conditions must be weighed in the decision-making process.

It has been suggested by many researchers based on results of studies that bilateral knee replacements are best done in high-volume hospitals by an experienced surgeon. Usually such facilities also have adequate intensive care units to care for patients who need close monitoring. Hospital staffing of nurses, operating room tech support, and experience of surgeon and staff are all important points.

A frank discussion with your surgeon and your physical therapist will help direct your decision. Don’t hesitate to bring up your family’s concerns. You will benefit from the experiences of other patients and families who have already had this procedure done.