Introduction: Juvenile idiopathic arthritis (JIA) poses lifelong challenges due to chronic inflammation that can lead to permanent deformities like autofusion, severely affecting quality of life.
Case Report: In this case, a 31-year-old female with a 21-year history of bilateral knee pain secondary to JIA faced a unique challenge: bilateral knee autofusion. Radiographs revealed severe bilateral contractures, erosive changes, and autofusion, prompting the decision for simultaneous total knee arthroplasties (TKAs).