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[two]

I am quite confused about this. If you do both legs together (bilaterally) there is a higher chance of creation of blood clots in the legs which can go to the lungs or brain.

If you do one leg first and then the other leg there is a lower chance of creation of blood clots but you are exposed to PE for a longer period of time (6 months in comparison to 3 months).

So is PE risk lower if you do it unilaterally instead of bilaterally?

[zaozari]

Dr. Monegal (Barcelona) says one leg only each time (both tibia and femur) has lower risk of fat embolism in general.

[two]

Dr. Monegal (Barcelona) says one leg only each time (both tibia and femur) has lower risk of fat embolism in general.

Does it hold for pulmonary as well?

[zaozari]

He just says "fat embolism syndrome":
http://www.limblengtheningforum.com/index.php?topic=734.0

[two]

Thanks but I wanted to know for pulmonary in particular. You have to be worried about it for 3 months after surgery, it can get taxing.

[Siegfried]

What is PE?

[two]

What is PE?

Pulmonary embolism.

[zaozari]

It scares me also, but the same way as if the embolism occurs in the brain or the heart.
It will be difficult to get precise information on that. Dr. Guichet for example says 2 surgeries (LL) in one  femur each, just generally double all risks in general.

[two]

It scares me also, but the same way as if the embolism occurs in the brain or the heart.
It will be difficult to get precise information on that. Dr. Guichet for example says 2 surgeries (LL) in one  femur each, just generally double all risks in general.

Where did he say that?  I don't think it doubles all risks especially not fat embolism. Thats why even Paley doesn't do quad in one day. If Guichet said the opposite I don't trust him.

I want to know about PE in particular, it's making me very uneasy thinking about it 

[zaozari]

I will try to find but I am sure, I think it's in his FAQ's

[zaozari]

Guichet is as competent and experienced as Paley, doctors have different approaches. But the surgery Guichet talks is only2 femurs OR two tibias, maybe that makes a difference.

[zaozari]

I am sorry, his site is new, I don't find any FAQs as such, and it seems not mentioned is the Risks.
But I am sure I have read it. He was just comparing one bone at a time with two bones, maybe. It makes sense to me: twice incisions, twice everything . It's something requiring more research. But why do you say you don't t trust him?

[two]

Many docs have confirmed that doing one leg first and later on another will reduce the chances of fat embolism (I don't know about pulmonary embolism however). If Guichet does not agree then I don't trust him.

Twice incisions but each time it is half the incisions. If they have to make 10 incisions for bilateral they will do 5+5 anyway right?

For me the biggest concern right now is PE pulmonary embolism. I wanna know the probability of getting it. If its more than 1% then I won't do this procedure.

[zaozari]

I don't know. It would be nice if you post here the links to the articles, even to confront/asking Guichet about it. But he seems a serious man, medicine is not an "exact science".
At least the risk of infection is surely higher, the number and duration of anaesthesia is doubled which has its own risks and is allways a bit harmful for the brain.
But I really don't know if there is, and which is, the right choice. Maybe there isn't a medical consensus.
Most doctors however do it bilaterally and could charge easily more for two surgeries instead of one, even "simpler".

[two]

I don't know. It would be nice if you post here the links to the articles, even to confront/asking Guichet about it. But he seems a serious man, medicine is not an "exact science".
At least the risk of infection is surely higher, the number and duration of anaesthesia is doubled which has its own risks and is allways a bit harmful for the brain.
But I really don't know if there is, and which is, the right choice. Maybe there isn't a medical consensus.
Most doctors however do it bilaterally and could charge easily more for two surgeries instead of one, even "simpler".

I will try to find some links. Paley's website has it for sure. And they recommend this for joint replacement surgeries also.

Risk of anesthesia is higher true.

but risk is infection is not higher. They will operate on a different leg each time, same number of incisions. You should obviously wait until your first leg's incisions have healed completely obviously.

[zaozari]

One of my main concerns is embolism, my blood is already thick.
 Are you opting for one leg only (twice) because of risk of pulmonary embolism alone or also for other reasons? And will you do femur or tibia only or both (femur and tibia) in the same leg each time?

[two]

Still thinking.

Other advantage is you can do precice and still walk on the healthy leg,.

check this link for double or single knee replacement it mentions about blood clots
https://www.hss.edu/conditions_expert-advice-on-bilateral-knee-replacement.asp

[zaozari]

Thanks.
Yes, it seems one more thing to evaluate and and also to talk with each candidate doctor.