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Bilateral Knee Replacement in Istanbul, Turkey: One-Stage or Staged?
For patients with advanced osteoarthritis in both knees, bilateral total knee arthroplasty can be indicated. The key decision is one-stage (simultaneous) versus two staged procedures. In Istanbul, Turkey, patient safety drives an individualized choice based on comorbidities, expectations and home support.
Who is a candidate for one-stage surgery?
- Low anesthetic risk: ASA I–II with controlled comorbidities
- Hemoglobin: ≥12 g/dL; low transfusion likelihood
- BMI < 35 and good cardiopulmonary reserve
- Low VTE risk with early mobilization & appropriate anticoagulation
- Reliable caregiver and safe home setting
When is staged safer?
- ASA ≥III; recent cardiac events, poorly controlled HT/DM, COPD
- BMI ≥35, Hb <12 g/dL, or higher bleeding risk
- Complex deformities with prolonged operative time
- Limited rehab capacity or frailty
Interval: Many centers use a 6–12 week gap between stages, adjusted to labs, wound healing and recovery.
One-stage vs staged: quick table
| Topic | One-Stage | Staged |
|---|---|---|
| Anesthesia | Single anesthesia and admission | Two anesthetics and admissions |
| Overall timeline | Potentially shorter hospital/leave time | Longer total timeline; more planning flexibility |
| Blood loss | Higher cumulative blood loss risk | Divided loss; easier management |
| Complications | Rare severe events in a single episode | Risk distributed; second stage optimized |
| Rehabilitation | Both knees at once; higher early support | Easier early mobility with one knee |
Team pathway in Istanbul (example)
- Pre-op: cardiology/internal medicine/anesthesiology as needed; ECG, chest X-ray, Hb, HbA1c
- Anesthesia: spinal + peripheral nerve blocks (e.g., adductor canal) with multimodal analgesia
- Blood management: tranexamic acid protocols; iron/B12 when appropriate
- VTE prophylaxis: early mobilization, compression, anticoagulation
- Rehab: day-1 mobilization; structured 1–12 week program
Cost and packages
Total cost varies by surgeon/team, implant choice (cemented/cementless), robotics/navigation, hospital and rehabilitation packages. Contact us for current Istanbul packages.
Free case review? Send your X-rays on WhatsApp; we usually reply within 24 hours.
Robotic Knee Replacement · Cost in Turkey · Recovery Timeline
FAQ
Is one-stage right for everyone?
No. It depends on ASA class, comorbidities, hemoglobin, BMI and home support.
Ideal gap between stages?
Commonly 6–12 weeks, tailored to labs, wound healing and recovery.
When can I fly?
After physician clearance; follow VTE prophylaxis and in-flight exercises.
