Double knee replacement requires two surgeons working simultaneously with two surgical assistants. Recovery is challenging with just one knee; and with two, independence in recovery can be very limited.

Story by: Lynne Choate; Reviewed by Jeffrey D. Stimac, M.D., and Kevin J. Himschoot, M.D. on January 23, 2024

Allen Sarven knows pain. But the pain that finally brought him to his knees was just that — knee pain.

Also known to World Wrestling Entertainment (WWE) fans as Al Snow, he has been a professional wrestler for 41 years. His career has taken him across states and continents, entertaining millions and winning championship titles, all the while taking an extreme toll on his body.

“I’ve fractured my neck twice; broken ribs and fingers; dislocated my right shoulder, separated my left; broke my elbow; broke my ankle; cracked my tailbone; dislocated my hip; tore my groin,” Al said. “I think I’m up to 14 times I’ve broken my nose. And I could go on.”

He began noticing his body was worn out and exhausted from compensating for the pain he was having in his knees in particular.

“I remember getting home from a simple 15-minute walk through the grocery store, putting the bags on the counter and going to sit on the couch because I was exhausted,” Al said.

His knees were, in his own words, completely destroyed. They were bone on bone, no cartilage left, and he could feel bone spurs that he describes as “gravel” under the skin.

“For most people, the need for knee replacement is due to osteoarthritis, which is more of a wear-and tear arthritis,” said Jeffrey D. Stimac, M.D., orthopedic surgeon, Norton Orthopedic Institute. “Some people can have more inflammatory arthritis, like rheumatoid arthritis or lupus arthritis, where it’s actually their immune system causing part of the problem. And then, in other situations, it’s injuries. In Al’s case, it was probably years and years of knee injuries during his wrestling career.”

By 2020, knee replacement surgery was in Al’s near future — and he had an unusual request. He wanted both knees replaced at the same time.

“This isn’t routine or normal,” Dr. Stimac said. “However, Al is not a normal patient.”

Dr. Stimac explained there are a few potential complications from having both knees replaced at the same time.

Al was well aware of these concerns, but he knew if he got one knee replaced and then was expected to take time to recover from a second surgery, he would struggle to find the time. Plus, with his self-discipline as an athlete and the encouragement of his wife, family and colleagues, he knew he could work through the rehabilitation process successfully.

“Double knee replacement requires two surgeons working simultaneously with two surgical assistants. The patient will be under anesthesia a little longer, and there is the concern of more blood loss during bilateral replacement. Perhaps the most concerning is the recovery. It’s challenging with just one knee, but to do both at one time, your independence is very limited.”

Jeffrey D. Stimac, M.D.

In October 2020, Al had his surgery at Norton Brownsboro Hospital. Dr. Stimac and his colleague, Kevin J. Himschoot, M.D., orthopedic surgeon, Norton Orthopedic Institute, scrubbed in for the two-hour surgery. Later that day, Al, with his wife by his side, started his first of several physical therapy sessions.

Al went home the following day, common for knee replacement surgeries, and got into the routine of going to physical therapy a few times a week for two weeks. He quickly realized most of the therapy exercises he could manage on his own, so he continued to push himself at home.

Al’s recovery wasn’t the norm, but then again this WWE superstar is an exception to most rules. According to Dr. Stimac, most people recovering from knee replacement surgery go through three months of physical therapy to be doing well, and full recovery can take up to a year.

“Al was such an active guy who still wrestled and still lifted weights daily — he was very fit coming into the surgery,” Dr. Stimac said. “I think that helped make his recovery much easier.”

And how is he now, three years after his double knee replacement?

“Knees are fantastic. Quite honestly, getting my knees replaced is probably the best thing I’ve ever done,” Al said. “The only regret I have is that I waited so long to finally make the decision to just go do it.”

While he isn’t doing suplexes or jumping from the top rope as much anymore, the former Hardcore Champion still finds himself in the wrestling ring as the co-owner and CEO of Ohio Valley Wrestling in Louisville, Kentucky.

Al reminisced about the first time he entered the ring during a show after his knee replacements.

“As part of the show I ran into the ring and I amazed myself as I took off. I was like, ‘Holy cow. I was able to actually run into the ring!’ In the not-so-distant past, I was concerned I wouldn’t be able to get up off the mat. But I did it without missing a beat. It was a showstopping moment for me.”

Al is thankful for his surgeons, Dr. Stimac and Dr. Himschoot.

“I cannot express my gratitude and my appreciation for basically giving me a whole new lease on life by replacing my knees,” Al said.

And to anyone considering knee replacement, or any big health decision for that matter, Al has some professional advice:

“If there’s anybody who is facing the replacement of their knees or hips, or facing any kind of choice where they need to make a decision, where they’ve been living a very challenging life because of whatever health issue is restricting them, go do it. Don’t hesitate. Without a question or a doubt, it is worth every bit of what you will go through to get to the other side. I tell people all the time, honestly, that this is probably one of the best things I’ve ever done for myself.”