Can both knees be replaced when the patient also has diabetes, an earlier spine operation and Parkinsonism?
Dr. Mahajan is Chairman Orthopaedics, Joint Replacement & Chief Robotic Joint Replacement at Max Smart Super Speciality Hospital, Saket.
A woman in her sixties came to Dr Ramneek Mahajan in a wheelchair, after five years of pain in both knees, with all three: diabetes, an earlier spine operation and Parkinsonism, a condition that causes slow movement and stiffness, often with shaking called tremors.
Why did the patient need surgery?
Dr Mahajan says the patient had severe osteoarthritis in both knees, the wearing away of the smooth surface inside the joint that leaves it stiff and painful, and could barely move a few steps. A family member says the patient had pain in both knees for five years, could not walk, and came to the hospital in a wheelchair.
Which operation was chosen?
Dr Mahajan says tests and CT scans, detailed X-rays that build pictures of the inside of the body, came first, and then the talk about surgery: he offered to replace both knees with a robot's help, the surgeon using a robotic arm to guide the cuts.
What made the operation riskier?
Dr Mahajan says three things came on top of the patient's arthritis: an earlier spine operation, diabetes, and Parkinsonism, whose tremors and stiffness were affecting her daily life.
How did the patient recover?
Dr Mahajan says the patient's pain was well controlled, and within six hours of the operation she was out of bed:
She went to the toilet.
She walked a few steps in the corridor.
Now, on the second day, she is walking alone.
A family member says both knees were replaced without any problem.
What should a patient with other illnesses tell the surgeon?
This is one woman's story, not a promise: what an operation can do for you depends on your own case.
Tell your surgeon about every earlier operation, and about diabetes or Parkinsonism, before the plan is made.
Ask what each one changes about the operation and the days after it.
What this case teaches
Both knees can be done in one operation or two; a 2026 review of 53 observational studies linked each to different risks.
Diabetes was linked to about twice the odds of infection after knee replacement, a 2025 overview of reviews found.
People with chronic conditions such as heart or kidney disease may be seen by a specialist before surgery, the American Academy of Orthopaedic Surgeons says.
Most people leave hospital 1 to 4 days after a knee replacement, and knee replacements in general last about 25 years, the NHS says.
