Many types of arthritis can cause degeneration of the knees. However, when both knees are significantly affected, this can complicate your options for a knee replacement. There are options to have both knees replaced simultaneously or improve pain and functionality in one knee, while having the other knee replaced.

Simultaneous Replacement

If you were relatively active before you started experiencing significant problems with both knees and have good upper-body strength and endurance, you may want to ask your doctor if there is the option to have both knees replaced simultaneously. Although having two knee replacements done at the same time can be taxing on the body, if you are relatively healthy, it may be a good option to help you get on your feet faster. Your strength and stamina will factor into how well your physical therapy goes after surgery.

Working with a physical therapist before surgery can also improve your odds of a successful bilateral knee replacement. Your physical therapist can work with you to maintain your current strength and lean body mass, which can significantly decline if you are not physically active. Maintaining as much strength as possible in both your upper and lower body will help you overcome the instability associated with learning to walk on two replaced knees.

Cartilage Repair

You may want to discuss with your doctor the possibility of having a cartilage replacement if you have one knee that is not as deteriorated as the other. This may give you the opportunity to have a minor procedure and prevent having both knees replaced simultaneously. Surgeons use several methods to help repair cartilage. One such method is creating microfractures in the cartilage. Causing small, controlled breaks in the cartilage can help stimulate new cartilage to grow.

A similar, but less precise, method requires drilling into the cartilage to encourage the formation of new cartilage. If you are a candidate for either procedure, the healing process can be lengthy while you wait for the cartilage to heal and grow. However, when successful, the procedure may result in less pain and better mobility in the treated knee, allowing you to continue with a knee replacement plan for the other knee.

Cartilage Transplants

Another option for the less deteriorated knee is to attempt a cartilage transplant. The main techniques used for cartilage transplants are using your own cartilage as the donor or in some instances cadaver tissue can be used. When using your own cartilage, the surgeon will remove healthy cartilage if it is located in an area of your knee that is less impacted by the force from walking. The piece of cartilage is relocated from the donor area to another part of your knee where the cartilage is thin or has worn away completely. Although using your own tissue is less risky than using cadaver tissue, in many cases of significant degeneration, there may not be enough healthy cartilage remaining for the option to be possible.

Once the transplant is completed, it can take up to two years for the cartilage to finish healing. The use of cadaver tissue is less widely available due to lack of acceptable donors. When available, the donor cartilage is cut into pieces or small holes are made in the cartilage and the donor tissue is glued to the recipient area. This allows your bone and cartilage to grow into the graft over time. More options are on the horizon to replace cartilage, which can delay or prevent knee replacements. For example, knee cartilage implants can prevent the need for donor cartilage and speed up the healing time.

When both knees are significantly affected by arthritis, your options can seem limited. If you will eventually need both knees replaced, there are ways to prevent the process from being overwhelming. For more information, contact a clinic like Town Center Orthopaedic Associates.