Bilateral TKR?

Gabrielle Morris

67yo female booked for bilateral TKR but “not if BMI > 40”

Background:

  • Severe OA in knees and feet 
  • Mobilises with walking stick
  • HTN
  • CFS 5
  • BMI just under 40

Issues

  • Appropriate to do bilateral TKR
    • Patient wishes for bilateral procedure as she is the primary carer for her husband with melanoma and was distressed at prospect of delay to second TKR
    • Frail older patient, recovery is likely to be slow, and her ability to support her husband (especially if she has a complication) may be severely impacted.

Discussion:

  • Who is a good candidate for bilateral TKR?
    • ASA 1-2
    • Patients aged 50-60 or younger.

Plan:

  • Discuss concerns with surgeon. Likely unilateral TKR.