Here are some facts regarding bilateral TKRs During a bilateral anything you get 1. double the length of anaesthetic this is significant because the stress on heart, lungs and body generally from being sedated and receiving amounts of drugs for the period of time involved can be problematic. A healthy person should be able to cope but even so, it will still leave the body with more recovery to cope with in the immediate and long term (see this Energy Drain for TKRs) 2. double the amount of surgical 'assault' and thus double the amount of repair, healing and recovery. This impact is significant as you can see from the Energy Drain chart 3. double the blood loss whilst this is true, most knee replacements, being done under tourniquet, have minimal blood loss anyway. But whilst a certain blood loss for one surgery may be easily tolerated by the body, double that loss at one go will also have an impact on the Energy Drain 4. double the demand on your body for healing and recovery as said in items 1, 2 and 3. I would therefore advise that, since people are frequently totally unprepared for the impact of surgery on their bodies and their general stamina from one replacement, it's often the case that recovery from a bilateral anything is more of an uphill struggle. This is okay if you are mentally and psychologically prepared but can be extremely distressing and frustrating if you are not.