Both Knees Replaced Together or One at a Time? How Dr. Ashish Singhal Decides
By Dr. Ashish Singhal, MS (Ortho), Orthopaedic & Robotic Joint Replacement Surgeon · Paras Hospital & Mahe Clinic, Udaipur · Medically reviewed October 2026
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Quick answer: If both knees are badly damaged or bent, Dr. Ashish Singhal usually recommends replacing both in one surgery, because the patient gets one admission, one recovery and two straight legs at once. If only one knee is bad, he replaces only that knee and tries to save the other with exercises, which often keeps it going for another 2–5 years. If the second knee is also worsening and will need surgery within a few months, both can be done together after a careful assessment of the patient's overall health.
It is one of the first questions patients ask once they hear the words "knee replacement": "Doctor, should I get both knees done together, or one at a time?" Some want it over with in one go. Others are afraid of doing both at once. Many have been told by relatives that "the other knee will go anyway, so do both now."
In this short video, Dr. Singhal explains exactly how he makes this decision for his patients in Udaipur.
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Key takeaways
Both knees badly damaged or deformed: both are usually replaced in a single surgery.
Only one knee badly damaged: only that knee is replaced; the other is protected with exercises.
Second knee mildly affected: Dr. Singhal often says a firm no to operating on it, even if the patient asks.
Second knee worsening and likely to need surgery within 2–3 months: both can be done together if the patient wishes and is fit.
The rule behind every decision: operate only when the knee truly needs it.
When are both knees replaced in one surgery?
When both knees are badly worn or visibly bent (bow legs or knock knees), Dr. Singhal's opinion is usually to do both at the same time. In his words: "एक ही बार में पेशेंट के दोनों घुटने सीधे हो जाएंगे" (both knees become straight in one go).
The practical benefits are clear:
One hospital admission instead of two.
One anaesthesia and one recovery period, with physiotherapy and exercises done together.
Both legs aligned at once, so the patient doesn't walk on one straight leg and one bent leg for months.
Whether both knees can safely be done together also depends on the patient's age, heart and lung health, and other conditions. That is assessed before surgery is planned. Robotic knee replacement can help here, as it typically involves less muscle disturbance, more precise bone cuts and less blood loss. Read more about robotic knee replacement in Udaipur.
When is only one knee replaced?
Very often, one knee is badly damaged while the other is only mildly affected. In that case, Dr. Singhal says he will not even advise changing the second knee. He replaces only the bad one and tries to save the other for as long as possible with exercises.
Something interesting often happens next. Once the worse knee is fixed, the patient walks properly again, the load is shared more evenly, and the other knee carries on comfortably for another two years, five years, or longer.
This is exactly what happened with one of Dr. Singhal's patients, a 78-year-old former state table-tennis champion who had his knees replaced years apart. Read his story: walking unaided 15 days after robotic knee replacement.
"Doctor, do both now. The other one will need it anyway."
Dr. Singhal hears this request often. His answer depends on one thing: does the second knee actually need surgery?
"If it's not that bad and we operate anyway, patients are not happy with that either," he explains. So if the second knee doesn't need surgery at this stage, and won't need it in the near future, he says a strict no.
But if he can see that the second knee is already deteriorating and will need replacement in the next two or three months, and the patient insists, then operating on both together is a sensible, calculated decision.
How the decision is made: at a glance
Your situation | Usual recommendation |
Both knees badly damaged or bent | Both knees replaced in one surgery, if fit |
One knee bad, other knee mildly affected | Replace the bad knee only; protect the other with exercises |
One knee bad, other knee worsening and likely to need surgery in 2–3 months | Both can be done together if the patient wishes |
Second knee not yet in need of surgery, but patient wants both done | Usually a firm no |
Not sure which situation you're in? An X-ray and an examination usually answer it. Learn how to tell which stage of knee arthritis each of your knees is at.
Not sure if your second knee really needs surgery? A free second opinion on knee replacement is available. Call +91 94143 93320 · WhatsApp
Frequently asked questions
Is it better to replace both knees at the same time or one at a time?
It depends on the condition of each knee and your overall health. If both knees are badly damaged, replacing both together means one admission and one recovery. If only one is bad, replacing just that knee and protecting the other is usually better.
If one knee is bad, will the other knee also need replacement?
Not necessarily, and not immediately. After the worse knee is replaced, the other knee often keeps working well for several more years with exercises.
How long can I delay replacing my second knee?
If it is only mildly affected, often 2–5 years or more. Your surgeon will monitor it and advise when it truly needs surgery.
Is bilateral knee replacement safe?
For suitable patients, yes. Safety depends on age, heart and lung health, and other medical conditions, which are checked before surgery.
Where can I get both knees replaced in Udaipur?
Dr. Ashish Singhal, Orthopaedic and Robotic Joint Replacement Surgeon, performs single and bilateral robotic knee replacement at Paras Hospital, Udaipur, and consults at Paras Hospital and Mahe Clinic. He has more than 20 years of experience and has performed over 1,600 robotic knee replacements.
हिंदी में: दोनों घुटने एक साथ या एक-एक करके?
संक्षिप्त जवाब: अगर दोनों घुटने बहुत ज़्यादा खराब या टेढ़े हैं, तो डॉ. आशीष सिंघल आमतौर पर दोनों को एक ही बार में बदलने की सलाह देते हैं। एक ही बार में admission, physiotherapy और exercise सब हो जाती है, और दोनों पैर एक साथ सीधे हो जाते हैं।
अगर एक घुटना बहुत खराब है और दूसरा उतना नहीं, तो सिर्फ खराब घुटना बदला जाता है और दूसरे को exercises से बचाने की कोशिश की जाती है। अक्सर दूसरा घुटना 2 से 5 साल या उससे ज़्यादा भी आराम से चल जाता है।
कई मरीज़ कहते हैं, "दूसरा भी थोड़े दिन में कराना ही पड़ेगा, अभी एक साथ कर दो।" डॉ. सिंघल के अनुसार, अगर दूसरे घुटने को अभी या निकट भविष्य में ज़रूरत नहीं है, तो वे साफ़ मना कर देते हैं। लेकिन अगर दूसरा घुटना भी खराब होने लगा है और 2–3 महीने में ज़रूरत पड़ने वाली है, तो मरीज़ की इच्छा पर दोनों का ऑपरेशन एक साथ किया जा सकता है।
क्या आपको दोनों घुटने बदलवाने की सलाह दी गई है? फैसला लेने से पहले सही राय लें। Knee replacement पर free second opinion उपलब्ध है। कॉल करें: +91 94143 93320 · WhatsApp करें
Book a consultation with Dr. Ashish Singhal
Don't decide about your knees on guesswork. One consultation can tell you whether you need one knee, both knees, or no surgery yet.
Call: +91 94143 93320 or +91 82091 69103
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Paras Hospital: Plot No. 1, JK Lane, Shobhagpura, Udaipur (directions)
Mahe Clinic: 140-141, Priyadarshini Nagar, Bedla Road, Udaipur (directions)
About Dr. Ashish Singhal
Dr. Ashish Singhal (MBBS, MS Orthopaedics, fellowship-trained in joint replacement and sports medicine) is an Orthopaedic and Robotic Joint Replacement Surgeon in Udaipur, Rajasthan, India. He practises at Paras Hospital and Mahe Clinic, has more than 20 years of surgical experience, and has performed over 1,600 robotic knee replacements. He answers everyday bone and joint questions on his YouTube channel.
Related reading: 6 causes of knee pain · Is knee replacement safe? Myths busted · Knee surgery costs in India · 90-year-old's robotic knee replacement
⭐ Add drashishsinghal.com as a preferred source on Google to see Dr. Singhal's answers first.
This article is for general information and does not replace a consultation. The right choice for your knees depends on your examination, X-rays and overall health.
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