Knee Arthritis in Both Knees: Dr. Mayur Rabhadiya Explains

Understanding Bilateral Knee Osteoarthritis

Knee arthritis may affect one knee or both knees.

When osteoarthritis is present in both knees, it is often called bilateral knee osteoarthritis.

The condition does not necessarily affect both sides equally.

A patient may have:

Mild arthritis in one knee and severe arthritis in the other
Similar X-ray findings but much greater pain on one side
Inner-compartment arthritis in one knee and kneecap arthritis in the other
Bow-leg alignment in both knees
Knock-knee alignment in both knees
Different deformities on each side
Severe stiffness in one knee but better movement in the other
One knee responding to treatment while the other continues to deteriorate

For this reason, treatment should not automatically be identical for both knees.

Each knee should be assessed according to:

Pain
Walking limitation
Stair difficulty
Swelling
Movement
Muscle strength
Alignment
Instability
X-ray findings
Previous injuries
Response to treatment
Effect on daily activities

Dr. Mayur Rabhadiya is an Orthopedic & Joint Replacement Surgeon in Mumbai with a focused clinical practice in knee arthritis, non-surgical knee care and partial, total and robotic knee replacement.

For a complete overview of treatment at every stage, visit Knee Arthritis Treatment in Mumbai by Dr. Mayur Rabhadiya.

Quick Answer: How Is Arthritis in Both Knees Treated?

Treatment may include:

Therapeutic exercise for both legs
Individual strengthening according to each knee
Weight management when appropriate
Activity modification
Physiotherapy
Medication in medically suitable patients
Walking aids
Bracing in selected cases
Injection treatment in one or both knees when appropriate
Replacement of only the more severely affected knee
Staged replacement of both knees
Simultaneous bilateral replacement in carefully selected patients

The treatment should not be chosen only because both X-rays show arthritis.

One knee may require surgery while the other remains manageable through non-surgical treatment.

Why Does Arthritis Affect Both Knees?

Bilateral knee arthritis may be associated with:

Age-related osteoarthritis
Genetic susceptibility
Body weight
Longstanding limb alignment
Repetitive occupational loading
Muscle weakness
Previous injuries
Inflammatory arthritis
Metabolic conditions
Similar mechanical loading of both knees

However, the two knees rarely have identical histories.

For example:

One knee may have sustained a previous ligament injury.
One knee may have undergone meniscal surgery.
One leg may have a previous fracture deformity.
One side may have worse bow-leg or knock-knee alignment.
The patient may habitually protect one knee and overload the other.

These differences can influence the rate and pattern of arthritis progression.

Common Symptoms in Both Knees

Symptoms may include:

Pain while walking
Reduced walking distance
Difficulty climbing stairs
Difficulty descending stairs
Stiffness after sitting
Pain during the first few steps
Difficulty getting up from a chair
Recurrent swelling
Clicking or grinding
Reduced knee bending
Difficulty fully straightening the knees
Weakness or buckling
Night pain
Rest pain
Reduced balance
Loss of independence

Symptoms may alternate between sides.

A patient may report:

“The right knee is usually worse, but the left knee has started hurting.”
“Both knees are painful, but only one swells.”
“One knee hurts during walking and the other hurts during stairs.”
“Both X-rays look bad, but only one knee limits me.”
“I cannot tell which knee should be treated first.”

A structured clinical assessment can help identify which knee is contributing most to the disability.

Can Both Knees Have Different Arthritis Grades?

Yes.

One knee may have:

Grade 1 or Grade 2 arthritis

while the other has:

Grade 3 or Grade 4 arthritis

The knees may also show different compartment involvement.

For example:

The right knee may have severe medial-compartment arthritis.
The left knee may have moderate patellofemoral arthritis.
One knee may be bone-on-bone.
The other may have only mild joint-space narrowing.

Treatment should follow the symptoms and functional effect of each side rather than automatically treating the higher X-ray grade.

Read Stages and Grades of Knee Arthritis.

Why Can the Less Arthritic-Looking Knee Hurt More?

Pain does not always correspond directly with the X-ray appearance.

The less abnormal-looking knee may be more painful because of:

Greater inflammation
Recurrent swelling
Meniscal irritation
Tendon pain
Patellofemoral pain
Muscle weakness
Instability
Greater daily loading
Referred pain from the hip or spine
A recent injury

The more severely arthritic knee may also be protected unconsciously, causing greater load through the opposite side.

Both knees should therefore be examined rather than selecting treatment from the reports alone.

Can One Knee Become Painful Because the Other Knee Is Arthritic?

Yes.

When one knee becomes painful, the patient may shift more body weight onto the opposite side.

This compensation may cause:

Overloading of the opposite knee
Increased hip or back pain
Altered walking
Reduced balance
Greater fatigue
Pain during stairs
Faster functional decline

Treating the more symptomatic knee may improve the walking pattern and reduce compensatory stress on the other side.

However, pain in the opposite knee should still be assessed independently rather than assumed to be compensation alone.

Different Pain Patterns in Each Knee

Pain While Walking

One or both knees may hurt after a predictable distance.

Read Knee Pain While Walking.

Pain During Stairs

One knee may be more painful during climbing, while the other is more painful during descent.

Read Knee Pain While Climbing Stairs.

Stiffness After Sitting

Both knees may feel stiff after travel, desk work or sleep.

Read Knee Stiffness After Sitting.

Difficulty Getting Up

When both knees are painful or weak, chair rise may become particularly difficult because the patient cannot shift weight onto a comfortable side.

Read Knee Pain While Getting Up From a Chair.

Night Pain

Both knees may disturb sleep, or the patient may be unable to find a position that relieves either side.

Read Why Knee Pain Is Worse at Night.

Swelling in Both Knees

Both knees may develop intermittent swelling because of osteoarthritis.

However, bilateral swelling may also raise the possibility of:

Rheumatoid arthritis
Another inflammatory arthritis
Gout or crystal arthritis
General fluid retention
Medication-related swelling
Heart, kidney or liver disease
Another systemic condition

Important details include:

Whether both knees swell at the same time
Whether they are warm or red
Whether other joints are affected
Duration of morning stiffness
Presence of fever
Ankle or leg swelling
Medical history
Current medication

A hot, red and severely painful knee requires prompt assessment.

Read Knee Swelling and Water in the Knee.

Bilateral Osteoarthritis Versus Inflammatory Arthritis

Osteoarthritis commonly affects both knees, especially in older adults.

However, inflammatory arthritis should be considered when the patient has:

Prolonged morning stiffness
Several swollen joints
Hand, wrist, foot or ankle involvement
Symmetrical joint inflammation
Fatigue
Recurrent warmth
Systemic symptoms

Blood tests and rheumatology assessment may be required when the clinical pattern is not typical of ordinary osteoarthritis.

Bilateral Knee Arthritis in Younger Adults

Younger adults may develop arthritis in both knees because of:

Previous sports injuries
Repeated meniscal injuries
Bilateral ligament instability
Patellar instability
Limb-alignment abnormalities
Previous fractures
Inflammatory arthritis
Genetic or developmental conditions
High occupational or sporting demands

Treatment may place greater emphasis on:

Joint preservation
Meniscal and ligament function
Alignment assessment
Muscle strength
Activity modification
Work and sporting goals
Delaying replacement when clinically appropriate

Read Knee Arthritis in Younger Adults.

How Arthritis in Both Knees Is Evaluated

Evaluation may include:

Detailed history for each knee
Standing alignment assessment
Walking assessment
Range-of-motion testing
Swelling assessment
Ligament testing
Muscle-strength assessment
Weight-bearing X-rays
Long-leg alignment X-rays in selected patients
MRI only for a defined clinical question
Blood tests when inflammatory arthritis is suspected

The objective is to determine:

Which knee is more symptomatic
Which knee limits walking more
Whether both knees require the same treatment
Whether one knee has an additional injury
Whether deformity is present
Whether surgery is appropriate
Which knee should be treated first

Symptoms Should Be Recorded Separately for Each Knee

It may help to record:

Clinical featureRight kneeLeft knee

Pain severity

Comfortable walking distance

Stair difficulty

Swelling

Night pain

Locking

Giving way

Movement restriction

Previous injury

Previous injection

Response to treatment

Separating the symptoms prevents the more dramatic X-ray from automatically controlling the treatment decision.

Weight-Bearing X-Rays of Both Knees

Standing X-rays may help assess:

Arthritis severity in each knee
Inner and outer joint spaces
Patellofemoral involvement
Bow-leg or knock-knee alignment
Bone spurs
Sclerosis
Bone-on-bone changes
Previous fracture or surgery
Relative severity between sides

Both knees may be imaged under similar conditions to improve comparison.

Read Knee Arthritis Diagnosis: Examination, X-Ray and MRI.

Is MRI Needed for Both Knees?

No.

MRI is not routinely required to diagnose typical bilateral knee osteoarthritis.

It may be considered for one knee when:

Symptoms are unusual
True locking is present
A meniscal or ligament injury is suspected
X-rays do not explain the pain
A stress injury is possible
A joint-preservation procedure is being considered

There is usually no reason to obtain MRI scans of both knees simply because both X-rays show arthritis.

Non-Surgical Treatment for Both Knees

Non-surgical care remains appropriate when:

Pain is manageable
Walking ability is acceptable
Daily activities remain possible
Deformity is limited
Symptoms respond to treatment
Surgery is not currently desired
Medical optimisation is required

Treatment may include:

Therapeutic exercise
Physiotherapy
Weight management
Activity modification
Medication
Walking aids
Selected braces
Injection treatment

Each knee may require a different combination.

Exercise for Bilateral Knee Arthritis

Exercise should strengthen both lower limbs.

A programme may include:

Quadriceps strengthening
Hip and gluteal strengthening
Hamstring strengthening
Calf strengthening
Knee range-of-motion exercises
Chair-rise practice
Balance exercises
Step-control exercises
Walking
Stationary cycling
Water-based exercise
General aerobic conditioning

When both knees are painful, exercises may need modification because the patient cannot rely on a comfortable leg for support.

Suitable adjustments may include:

Seated exercises
Supported standing exercises
Higher chairs
Reduced squat depth
Lower step height
Water-based rehabilitation
Gradual progression

Should Both Knees Perform the Same Exercises?

Not always.

One knee may have:

Greater stiffness
More weakness
More swelling
Greater deformity
Previous ligament injury
Recent surgery

The exercise programme may therefore use:

Different resistance on each side
Different movement ranges
Different repetition numbers
Different balance support
Different progression rates

The overall goal is balanced lower-limb strength without ignoring the limitations of the more painful knee.

Walking With Arthritis in Both Knees

Walking remains important for:

Mobility
Cardiovascular health
Muscle endurance
Weight management
Independence

A walking programme may involve:

Shorter distances
Level surfaces
Planned rest breaks
Gradual progression
Appropriate footwear
Use of a walking aid
Monitoring next-day symptoms

A patient should seek reassessment when:

Walking distance steadily reduces
Limping becomes persistent
Both knees repeatedly swell
Falls occur
Leaving home becomes difficult
The patient is increasingly dependent on family

Which Hand Should Hold a Walking Stick?

When one knee is clearly more painful, a walking stick is generally held in the opposite hand.

When both knees are painful, the choice depends on:

Which knee is worse
Balance
Upper-limb strength
Walking pattern
Fall risk

Some patients may benefit more from:

Two walking sticks
Crutches
A walking frame
A rollator

The walking aid should improve safety rather than simply be selected by appearance.

Weight Management

For patients living with overweight or obesity, gradual weight reduction may improve pain and physical function in both knees.

The programme should preserve muscle through:

Adequate nutrition
Sufficient protein
Strength training
Sustainable calorie reduction
Management of diabetes and other medical conditions

Weight management may improve symptoms but does not recreate lost cartilage or correct fixed deformity.

Medication When Both Knees Are Painful

Medication decisions should consider the total dose rather than treating each knee separately.

Using more medication because both knees hurt may increase the risk of:

Kidney injury
Stomach irritation or bleeding
Blood-pressure changes
Cardiovascular complications
Liver toxicity
Drug interactions
Falls or sedation with certain medicines

Medication should support exercise and function.

It should not replace reassessment when mobility continues to decline.

Can Braces Be Used on Both Knees?

Braces may be considered when:

Instability is present
Arthritis is concentrated in one compartment
Abnormal loading contributes to symptoms
Exercise alone is insufficient or unsuitable
A brace clearly improves walking

Wearing braces on both knees may be:

Bulky
Uncomfortable
Difficult to apply
Expensive
Hard to tolerate throughout the day

The expected functional benefit should justify their use.

Injections in Both Knees

An injection may be considered for one or both knees when:

The diagnosis is clear
Symptoms remain functionally limiting
Initial non-surgical treatment has been insufficient
The expected benefit is realistic
There is no contraindication

The two knees do not automatically require:

The same injection
The same dose
Treatment on the same date
Repeated treatment at the same interval

One knee may be suitable for injection while the other requires continued rehabilitation or surgical assessment.

Corticosteroid Injections in Both Knees

Corticosteroid injections may provide short-term symptom relief in selected patients.

Before treating both knees, the clinician should consider:

Diabetes
Blood-glucose control
Infection risk
Previous response
Frequency of past injections
Medical conditions
Planned surgery
Total medication exposure

A suddenly hot or unexplained swollen knee should be assessed before routine injection treatment.

GFC Therapy in Both Knees

GFC therapy may be considered in selected patients with symptomatic knee osteoarthritis.

Suitability should be assessed separately for each knee according to:

Arthritis stage
Pain pattern
Swelling
Joint alignment
Movement
Walking limitation
Previous treatment
Patient expectations

One knee may be a more suitable candidate than the other.

For example:

A moderately arthritic knee may have a reasonable non-surgical treatment opportunity.
A severely deformed bone-on-bone knee may be less likely to obtain adequate benefit from an injection.

GFC should not be presented as:

A guaranteed cartilage-regeneration treatment
A permanent cure
A method of correcting deformity
A substitute for replacement in every advanced knee

Learn more about GFC Therapy for Knee Arthritis.

Patients comparing platelet-based options can read GFC Therapy vs PRP.

Should Both Knees Receive Injections on the Same Day?

This may be considered in selected patients, but it is not automatically necessary.

The decision depends on:

Type of injection
Medical history
Diabetes
Infection risk
Previous response
Severity in each knee
Ability to rest and monitor both knees
Planned surgery
Expected functional benefit

Treating both knees may temporarily make walking or rehabilitation more difficult if both become sore after the procedure.

The benefits and practical limitations should be discussed beforehand.

Can One Knee Be Treated Non-Surgically While the Other Is Replaced?

Yes.

This is common when:

One knee has severe arthritis and major disability
The other knee has mild or moderate disease
The less affected knee responds to exercise
Only one side has major deformity
One knee has failed non-surgical treatment
The patient prefers staged treatment

Replacing the more severely affected knee may also improve the patient’s overall walking pattern.

The opposite knee should still be monitored and treated according to its own symptoms.

How Is the First Knee Selected for Replacement?

When both knees are arthritic, the first knee is commonly selected according to:

Greater pain
Greater walking limitation
Worse night pain
More severe deformity
More restricted movement
Greater instability
More frequent swelling
Greater effect on daily activities
Patient preference
Rehabilitation considerations

The worse-looking X-ray is not always the correct knee to operate on first.

The decision should be confirmed through clinical history and examination.

What Is Staged Bilateral Knee Replacement?

Staged bilateral knee replacement means that the knees are replaced during separate operations.

The interval may vary according to:

Recovery from the first operation
Medical fitness
Anaemia
Strength
Walking ability
Home support
Severity of the second knee
Patient preference
Surgical advice

Potential advantages include:

Lower immediate physiological demand
Ability to assess recovery from the first operation
Time to improve strength before the second operation
Easier early mobilisation for some patients
Opportunity to reconsider the second surgery if symptoms improve

Potential disadvantages include:

Two hospital admissions
Two anaesthetic episodes
Two separate rehabilitation periods
Longer overall treatment duration
Continued symptoms from the untreated knee

What Is Simultaneous Bilateral Knee Replacement?

Simultaneous bilateral knee replacement means that both knees are replaced during the same anaesthetic and hospital admission.

Potential practical advantages may include:

One hospital admission
One anaesthetic episode
One combined rehabilitation period
A shorter total treatment timeline

However, the operation creates greater immediate physiological and rehabilitation demands.

It may involve:

Greater blood-loss considerations
Increased anaemia risk
More demanding early mobilisation
Greater need for assistance
More complex pain management
Higher dependence during early recovery
Careful assessment of medical risks

It is not appropriate for every patient.

Who May Be Considered for Simultaneous Bilateral Replacement?

Suitability requires individual medical and surgical assessment.

Factors may include:

Severe symptomatic arthritis in both knees
Good overall medical fitness
Acceptable heart and lung health
Adequate kidney function
Controlled diabetes
Acceptable haemoglobin
Limited frailty
Adequate muscle strength
Realistic expectations
Strong family or rehabilitation support
Ability to participate in intensive rehabilitation

The decision should not be based only on age or the fact that both knees are bone-on-bone.

Who May Be Better Suited to Staged Surgery?

Staged surgery may be preferred when the patient has:

Significant heart disease
Significant lung disease
Kidney disease
Anaemia
Frailty
Poor balance
Limited home support
Major difference in symptom severity
Uncertainty about the second knee
Greater rehabilitation risk
A need for medical optimisation

The safer approach depends on the complete clinical assessment.

Can Both Knees Be Replaced if One Is Much Worse?

Yes, but replacing both simultaneously may not be necessary.

When one knee is clearly more disabling, the usual approach may be to:

Replace the more symptomatic knee.
Complete initial rehabilitation.
Reassess the opposite knee.
Continue non-surgical treatment if the second knee remains manageable.
Schedule the second replacement if symptoms justify it.

Some patients find that the second knee remains limiting. Others experience improved overall mobility and prefer to delay its operation.

Can Partial Knee Replacement Be Performed in Both Knees?

Bilateral partial knee replacement may be possible in selected patients when each knee independently meets the criteria.

Suitability may require:

Arthritis limited to one suitable compartment
Appropriate ligament function
Preserved remaining compartments
Acceptable movement
Correctable deformity
Symptoms corresponding with the affected compartment

One knee may be suitable for partial replacement while the other requires total replacement.

Learn more about Partial Knee Replacement in Mumbai.

Can One Knee Receive Partial Replacement and the Other Total Replacement?

Yes.

The procedure should be selected according to each knee’s:

Arthritis distribution
Ligament condition
Alignment
Movement
Bone condition
Symptoms
Surgical goals

The same implant type is not automatically required on both sides.

Total Knee Replacement for Both Knees

Total knee replacement may be considered for each knee when:

Arthritis affects several compartments
Pain and disability are substantial
Deformity is significant
Non-surgical treatment is ineffective
The patient is medically suitable
Expected benefits justify the risks

Learn more about Total Knee Replacement in Mumbai.

For the complete surgical overview, visit Knee Replacement Surgery in Mumbai.

Robotic Replacement in Both Knees

Robotic systems may assist the surgeon with:

Planning each knee separately
Assessing individual alignment
Bone preparation
Implant positioning
Evaluation of joint balance

The anatomy and deformity of the right knee may differ from the left.

The technology does not:

Decide which knee requires surgery
Decide whether both should be replaced together
Independently perform the operation
Replace surgical judgement
Remove the need for rehabilitation

Learn more about Robotic Knee Replacement in Mumbai.

Rehabilitation When Both Knees Are Arthritic

Rehabilitation may be more challenging because the untreated or recently operated opposite knee cannot always provide reliable support.

The plan may include:

Preoperative strengthening of both legs
Walking-aid training
Chair-rise practice
Balance exercises
Home preparation
Family-support planning
Postoperative physiotherapy
Fall-prevention measures
Gradual walking progression

Preparing the less painful knee before surgery can be important because it may initially carry greater load after the first operation.

Home Preparation

Practical preparation may include:

Stable chair with armrests
Raised toilet seat when appropriate
Removal of loose rugs
Clear walking pathways
Handrails
Appropriate footwear
Accessible sleeping arrangements
Help with meals and household work
Transport planning
Medication organisation

The amount of help required may be greater after simultaneous bilateral surgery.

Can Knee Replacement in One Knee Increase Pain in the Other?

The opposite knee may temporarily become more painful because it carries greater load during early recovery.

This may be influenced by:

Pre-existing arthritis
Weakness
Walking-aid use
Altered gait
Reduced confidence
Rehabilitation demands

Preoperative planning should consider whether the opposite knee can safely support recovery.

Does Replacing One Knee Improve the Other Knee?

Replacement does not treat the structural arthritis in the opposite knee.

However, improved alignment, reduced pain and a better walking pattern may reduce compensatory stress.

Some patients report improved overall mobility after the first operation. Others continue to experience significant symptoms from the untreated side.

The second knee should be reassessed after recovery rather than assuming that it will definitely require immediate surgery.

When Should Replacement Be Considered?

Replacement may be considered for one or both knees when:

Pain is persistent and severe
Walking distance is substantially reduced
Stairs are severely difficult
Deformity is progressing
Night or rest pain is present
Knee movement is substantially restricted
Instability is present
Independence is declining
Suitable non-surgical treatment is ineffective or unsuitable

Read When Does Knee Arthritis Need Knee Replacement?.

When Should Surgery Be Delayed?

Surgery may be delayed when:

Symptoms remain manageable
Function is acceptable
The diagnosis is uncertain
Medical conditions need optimisation
Diabetes is poorly controlled
Anaemia is present
Infection risk is elevated
Muscle strength is poor
The patient is not ready
Home support is inadequate
Expected benefit is uncertain

A short delay for optimisation may improve safety and rehabilitation.

When Can Excessive Delay Become Unhelpful?

Prolonged delay in a severely disabled patient may contribute to:

Greater muscle weakness
Reduced knee movement
Progressive deformity
Falls
Reduced cardiovascular fitness
Weight gain from inactivity
Loss of independence
Greater rehabilitation difficulty
Social isolation

Timing should be individualised.

Arthritis Progression in Both Knees

The two knees may progress at different rates.

One knee may remain stable while the other develops:

Greater joint-space loss
Increasing deformity
Recurrent swelling
Reduced movement
Night pain
Instability

Routine repeated imaging is not required when symptoms and function remain stable.

Updated X-rays may be appropriate when:

Symptoms have substantially changed
Walking ability is declining
Deformity is progressing
Surgery is being planned
Another diagnosis is suspected

Read How Fast Does Knee Arthritis Progress?.

Arthritis Flare-Ups in Both Knees

A flare may affect:

One knee
Both knees simultaneously
Each knee at different times

If both knees suddenly become hot, swollen or severely painful, ordinary osteoarthritis should not be assumed without assessment.

Possible causes include:

Inflammatory arthritis
Gout or crystal arthritis
Infection
A systemic condition
Activity-related flare

Read Knee Arthritis Flare-Ups.

When Symptoms Need Prompt Medical Attention

Seek prompt assessment when there is:

A hot, red and severely painful knee
Rapidly increasing swelling
Fever, chills or feeling unwell
Inability to bear weight
Major recent trauma
A knee that remains locked
New numbness or weakness
Sudden calf swelling
Breathlessness or chest pain
Severe symptoms after surgery
Severe symptoms after an injection

These features may indicate infection, fracture, vascular disease or another condition requiring urgent treatment.

When to Consult a Knee Arthritis and Replacement Surgeon

Consider orthopedic assessment when:

Both knees are persistently painful
Walking distance is reducing
Both knees repeatedly swell
One knee is significantly worse
Bow-leg or knock-knee deformity is progressing
The knees are unstable
Exercise and medication no longer provide adequate relief
Injections are being considered
Both knees have been advised replacement
You are uncertain which knee should be treated first
Simultaneous bilateral replacement has been suggested
You require a second opinion

Assessment does not automatically lead to replacement of both knees.

It helps determine the most appropriate treatment and sequence for each side.

Why Patients Consult Dr. Mayur Rabhadiya for Arthritis in Both Knees

Dr. Mayur Rabhadiya follows an evidence-based and patient-specific approach to bilateral knee arthritis.

His clinical assessment emphasises:

Evaluating each knee independently
Correlating symptoms with weight-bearing X-rays
Identifying the knee causing the greatest disability
Assessing alignment, movement and stability
Planning exercise for both legs
Reviewing injection suitability separately for each knee
Avoiding premature bilateral surgery
Selecting which knee should be treated first
Assessing staged versus simultaneous replacement carefully
Choosing partial, total, robotic or conventional replacement according to each knee

Bilateral Knee-Arthritis Treatment in Ghatkopar, Mumbai

Dr. Mayur Rabhadiya consults at clinics in Ghatkopar East and Ghatkopar West.

Diabplus Clinic, Ghatkopar East

601, 6th Floor, Skyline Status, Mahatma Gandhi Road, opposite Pooja Hotel, Pant Nagar, Ghatkopar East, Mumbai, Maharashtra 400077.

Learn more about consulting Dr. Mayur Rabhadiya in Ghatkopar East.

Savla Clinic, Ghatkopar West

2/3, Dharmodaya Building, next to Raj Medical, near NULife Hospital, Jivdaya Lane, Ghatkopar West, Mumbai, Maharashtra 400086.

Learn more about consulting Dr. Mayur Rabhadiya in Ghatkopar West.

Frequently Asked Questions About Arthritis in Both Knees

What does bilateral knee arthritis mean?

It means that arthritis affects both knee joints.

Do both knees usually have the same arthritis grade?

No. One knee may have mild disease while the other has moderate or severe arthritis.

Why does one knee hurt more when both X-rays look similar?

Pain is influenced by inflammation, swelling, muscle strength, instability, meniscal problems and activity—not only the X-ray grade.

Can treating one knee reduce pain in the other?

Improved walking after treatment may reduce compensatory loading, but it does not reverse structural arthritis in the opposite knee.

Should both knees perform the same exercises?

Not always. Exercise resistance, movement range and progression may need to differ between sides.

Can I continue walking when both knees are arthritic?

Yes, within a safe and tolerable range. Distance, pace, surfaces and walking aids may need adjustment.

Which hand should hold a walking stick?

When one knee is worse, the stick is generally held in the opposite hand. Bilateral symptoms may require individual walking-aid assessment.

Can braces be worn on both knees?

They can, but comfort, fit and functional benefit should be assessed. Braces are not routinely necessary for every patient.

Can both knees receive injections?

Yes, in selected patients, but each knee should independently meet the clinical indication.

Can both knees receive GFC on the same day?

This may be considered in selected patients after reviewing arthritis stage, medical history, practical recovery needs and expected benefit.

Does GFC work equally in both knees?

Not necessarily. Response may differ because the knees may have different arthritis stages, alignment and symptoms.

If both knees are bone-on-bone, do both need replacement?

Not automatically. Surgery depends on pain, function, deformity, treatment response and medical fitness.

Which knee should be replaced first?

Usually the knee causing greater pain, disability, deformity or instability, after clinical assessment.

Can both knees be replaced during one operation?

Simultaneous bilateral replacement may be considered in carefully selected, medically suitable patients.

Is simultaneous bilateral knee replacement safe for everyone?

No. It creates greater immediate physiological and rehabilitation demands and requires careful risk assessment.

What is staged bilateral knee replacement?

It means replacing the knees during two separate operations.

How long should the interval be between staged replacements?

There is no single interval for every patient. Timing depends on recovery, strength, anaemia, medical fitness and symptoms in the second knee.

Is recovery harder after both knees are replaced together?

Early rehabilitation is usually more demanding because neither knee can serve as a comfortable supporting side.

Can one knee receive partial replacement and the other total replacement?

Yes, when each procedure matches the arthritis distribution and condition of that knee.

Can robotic surgery be used for both knees?

Robotic assistance may be used for each suitable knee, but the surgical plan is individualised for each side.

Does replacing one knee mean the other must be replaced later?

No. The second knee may remain manageable with non-surgical treatment.

When should I consult a knee-replacement surgeon?

Assessment is advisable when both knees significantly restrict walking, stairs, sleep or independence despite appropriate treatment.

About the Author

Dr. Mayur Rabhadiya
Orthopedic & Joint Replacement Surgeon

Qualifications

MBBS
D’Ortho
DNB Orthopedics
MNAMS Orthopedics
Fellowship in Robotic & Computer-Navigated Joint Replacement

Clinical focus

Bilateral knee osteoarthritis
Non-surgical knee-arthritis treatment
GFC therapy in selected patients
Partial knee replacement
Total knee replacement
Staged and simultaneous bilateral replacement assessment
Robotic and conventional knee replacement
Revision knee replacement

Written and medically reviewed by: Dr. Mayur Rabhadiya
Last medically reviewed: June 2026

Clinical References

Book a Consultation With Dr. Mayur Rabhadiya

Consultation may be useful if:

Both knees are persistently painful
Walking distance is reducing
Both knees repeatedly swell
One knee is substantially worse than the other
Bow-leg or knock-knee deformity is progressing
Injections are being considered
Both knees have been advised replacement
You are uncertain which knee should be operated on first
Staged or simultaneous bilateral replacement has been suggested
You require a second opinion

Book an orthopedic consultation with Dr. Mayur Rabhadiya in Ghatkopar, Mumbai

Call or WhatsApp

+91 84249 03913
+91 96113 30063

Medical Disclaimer

This page is intended for patient education and general information. It is not a substitute for individual medical consultation, examination or diagnosis. Suitability for injections, staged replacement or simultaneous bilateral knee replacement depends on symptoms, medical fitness, anaemia, heart and lung health, kidney function, surgical risk, rehabilitation potential and home support. A hot red knee, rapid swelling, fever, inability to bear weight, major trauma, true locking, sudden calf swelling, breathlessness or severe symptoms after surgery or injection require prompt medical assessment.