Bilateral simultaneous medial partial knee replacements


I think patients are really quite nervous in the UK about having either partial or total knee replacements done simultaneously.

This operation is not done that commonly in the UK mainly because most units just don't have the setup. When you do have an appropriate setup its an operation that patients bounce back from very nicely. It saves them two inpatient stays and two surgical procedures if you can do the procedures combined, which was the case here.

This lady - Janet - is 71 and came to see me within the last year (2016) with really severe medial osteoarthritis. Both the patellofemoral and lateral compartments were good, and her ACLs were intact. We discussed the options and she elected to go for bilateral simultaneous partial knee replacements which were carried out 13 days ago (ie early June 2017).

You can also see that she has a very nice range of motion in both knees at 13 days. In fact, her husband has had to slow her down and stop her doing too much in the garden, which I think is a good thing in this very early phase following her surgery.

At 6 weeks...

Six weeks ago she underwent bilateral simultaneous partial knee replacements under my care. This is an operation that works extremely well when you have the right set-up. Obviously having a Fellow and the great team that we have in Basingstoke means that we can do these simultaneous bilateral operations, and patients really do benefit from having two sides done under one anaesthetic.

In Janet's case the right knee was much more worn than the left and it has taken a little bit longer to get over this but I think you can see from the post-op appearances what is possible when somebody undergoes a bilateral procedure simultaneously.

We can see her above at the early 13-day stage when she is off her crutches and walking pretty much pain free, and that does show her doing exceptionally well as this is fairly uncommon although not unheard of. If surgery is on only one side then it is often like this, but when you do two sides together people can be a little slow - but the video just shows that Janet was able to get up and get going without crutches quite quickly.

Now here you can see her walking at the 6 weeks without crutches and a normal gait, pain free, and is looking forward to getting back into the garden to deal with the weeds that have grown over the last few months while she has been rehabilitating.Wherever possible I think we should do partial knee replacements rather than total, and again this shows what an excellent result and great early function can be achieved.

adrian wilson

Adrian Wilson

I think it is important to show examples of cases where patients do well, and this is not that untypical. You can see from the video that Mrs Montague-Brown is off her crutches and walking well and comfortably at this early stage.

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